1,2,4-oxadiazole and 1,2,4-thiadiazole beta-lactamase inhibitors

ABSTRACT

β-Lactamase inhibitor compounds (BLIs) are disclosed, including compounds that have activity against class A, class C or class D β-lactamases. Methods of manufacturing the BLIs, and uses of the compounds in the preparation of pharmaceutical compositions and antibacterial applications are also disclosed.

RELATED APPLICATIONS

This application claims priority to U.S. Provisional Application No.61/618,136, filed Mar. 30, 2012. The entire content of this applicationis incorporated herein by reference in its entirety.

TECHNICAL FIELD

This disclosure is directed to β-lactamase inhibitors (BLIs) which areeffective as inhibitors of β-lactamases and, when used in combinationwith β-lactam antibiotics are useful in the treatment of bacterialinfections. The compounds when combined with a β-lactam antibiotic areeffective in treating bacteria that are resistant to β-lactamantibiotics due to the presence of β-lactamases. Pharmaceuticalcompositions comprising such compounds, methods of using such compounds,and processes for preparing such compounds are also disclosed.

BACKGROUND

Bacterial resistance to β-lactam antibiotics, especially inGram-negative bacteria, is most commonly mediated by β-lactamases.β-lactamases are enzymes that catalyze the hydrolysis of the β-lactamring, which inactivates the antibacterial activity of the β-lactamantibiotic and allows the bacteria to become resistant. Inhibition ofthe β-lactamase with a BLI slows or prevents degradation of the β-lactamantibiotic and restores β-lactam antibiotic susceptibility toβ-lactamase producing bacteria. Many of these β-lactamases are noteffectively inhibited by BLIs currently on the market rendering theβ-lactam antibiotics ineffective in treating bacteria that produce theseβ-lactamases. There is an urgent need for novel BLIs that inhibitβ-lactamases that are not effectively inhibited by the current clinicalBLIs (e.g. KPC, class C and class D β-lactamases) and that could be usedin combination with β-lactam antibiotics to treat infections caused byβ-lactam resistant bacteria.

SUMMARY OF INVENTION

The present invention provides, in one aspect, compounds of chemicalformula (I), or pharmaceutically-acceptable salts thereof, which areBLIs and are useful in combination with β-lactam antibiotics for thetreatment of bacterial infections.

A compound of Formula (I) or a pharmaceutically acceptable salt thereof:

-   -   wherein

Z is selected from a 1,2,4-oxadiazole or a 1,2,4-thiadiazole;

R is selected from

R¹ is selected from:

-   -   a. hydrogen,    -   b.

-   -   -   wherein R² is selected from

-   -   -   wherein each of R³, R⁴ and R⁵ is independently selected from            hydrogen, (C₁-C₃)-alkyl, aminoalkyl, aminocycloalkyl, or            hydroxyalkyl, and n is selected from 1, 2 or 3,

    -   c. amino,

    -   d.

-   -   -   wherein R⁶ is selected from H, (C₁-C₃)-unsubstituted alkyl,            amino-(C₂-C₃)-alkyl, aminocycloalkyl, hydroxyalkyl,

-   -   -   and each of p and q is independently selected from 1 or 2;            and

    -   e. —CH₂(R⁷)CH₂NH₂        -   wherein R⁷ is selected from amino or hydroxyl.

In another aspect, the invention provides use of a compound of Formula Ifor inhibiting β-lactamases.

In yet another aspect, the invention provides compounds of Formula Iwith high binding affinity for β-lactamase enzymes.

In a further aspect, the present invention also provides antibacterialcompositions comprising compounds of Formula I and at least one β-lactamantibiotic.

In an even further embodiment, the present invention providespharmaceutical compositions comprising compounds of Formula I and atleast one β-lactam antibiotic and methods of use thereof.

In a still further aspect, the invention provides methods of use of thecompounds of Formula I to treat bacterial infections in a subject.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows Table I, Representative Compounds of Formula II

FIGS. 2 a-2 b show Table II, Standard BLI potentiation MIC assay againsta panel of isogenic and clinical strains expressing β-lactamases.

FIG. 3 shows Table III, the synergy MIC of representative compounds ofFormula I against a panel of isogenic and clinical strains expressingβ-lactamases.

FIG. 4 shows Table IV, an assay to determine inhibition kinetics ofrepresentative compounds of Formula I for the KPC-2 β-lactamase.

DETAILED DESCRIPTION Definitions

Molecular terms, when used in this application, have their commonmeaning unless otherwise specified.

The term “alkyl” is defined as a linear or branched, saturated radicalhaving one to about twenty carbon atoms unless otherwise specified.Preferred alkyl radicals are “lower alkyl” radicals having one to aboutfive carbon atoms. Examples of alkyl groups include, without limitation,methyl, ethyl, tert-butyl, isopropyl, and hexyl. A subset of the termalkyl is “(C₁-C₃)-unsubstituted alkyl” which is defined as an alkylgroup that bears no substituent groups. Examples of(C₁-C₃)-unsubstituted alkyl groups include methyl, ethyl, propyl andisopropyl. It is understood that if a (C₁-C₃)-alkyl is “substituted”that one or more hydrogen atoms is replaced by a substitutent.

The term amino denotes a NH₂ radical

The term “aminoalkyl” denotes an alkyl in which one or more of the alkylhydrogen atoms has been replaced by an amino group.

The term “aminocycloalkyl” denotes a cycloalkyl in which one of thecycloalkyl hydrogen atoms has been replaced by an amino group.

The term “cycloalkyl” or “cycloalkyl ring” is defined as a saturated orpartially unsaturated carbocyclic ring in a single or fused carbocyclicring system having from three to twelve ring members. In a preferredembodiment, a cycloalkyl is a ring system having three to seven ringmembers. Examples of a cycloalkyl group include, without limitation,cyclopropyl, cyclobutyl, cyclohexyl, and cycloheptyl.

The term “hydroxyalkyl” denotes an alkyl radical in which one or more ofthe alkyl hydrogen atoms has been replaced by a hydroxyl group.

It will be understood by one of skill in the art that a

or—

denote the point of attachment of a substituent group where indicated.For example

or —C(O)NHR⁵

represent that the point of attachment of the amide moiety is at thecarbonyl carbon.

The functional classification of β-lactamases and terms “Class A”,“Class C”, and “Class D” β-lactamases are understood by one of skill inthe art and are described in “Updated Functinal Classification ofβ-Lactamases”, Bush, K.; Jacoby, G. A.; Antimicrob. Agents Chemother.2010, 54, 969-976, herein incorporated by reference.

The salts of the compounds of the invention include acid addition saltsand base addition salts. In a one embodiment, the salt is apharmaceutically acceptable salt of the compound of Formula I. The term“pharmaceutically acceptable salts” embraces salts commonly used to formalkali metal salts and to form addition salts of free acids or freebases. The nature of the salt is not critical, provided that it ispharmaceutically-acceptable. Suitable pharmaceutically acceptable acidaddition salts of the compounds of the invention may be prepared from aninorganic acid or an organic acid. Examples of such inorganic acidsinclude, without limitation, hydrochloric, hydrobromic, hydroiodic,nitric, carbonic, sulfuric and phosphoric acid. Examples of appropriateorganic acids may be selected from aliphatic, cycloaliphatic, aromatic,arylaliphatic, heterocyclic, carboxylic and sulfonic classes of organicacids, examples of which include, without limitation, formic, acetic,propionic, succinic, glycolic, gluconic, maleic, embonic (pamoic),methanesulfonic, ethanesulfonic, 2-hydroxyethanesulfonic, pantothenic,benzenesulfonic, toluenesulfonic, sulfanilic, mesylic,cyclohexylaminosulfonic, stearic, algenic, β-hydroxybutyric, malonic,galactic, and galacturonic acid. Suitable pharmaceutically-acceptablebase addition salts of compounds of the invention include, but are notlimited to, metallic salts made from aluminum, calcium, lithium,magnesium, potassium, sodium and zinc or organic salts made fromN,N′-dibenzylethylenediamine, chloroprocaine, choline, diethanolamine,ethylenediamine, N-methylglucamine, lysine and procaine. All of thesesalts may be prepared by conventional means from the correspondingcompound of the invention by treating, for example, the compound of theinvention with the appropriate acid or base.

The compounds of the invention can possess one or more asymmetric carbonatoms and are thus capable of existing in the form of optical isomers aswell as in the form of racemic or non-racemic mixtures thereof. Thecompounds of the invention can be utilized in the present invention as asingle isomer or as a mixture of stereochemical isomeric forms.Diastereoisomers, i.e., nonsuperimposable stereochemical isomers, can beseparated by conventional means such as chromatography, distillation,crystallization or sublimation. The optical isomers can be obtained byresolution of the racemic mixtures according to conventional processes,for example by formation of diastereoisomeric salts by treatment with anoptically active acid or base. Examples of appropriate acids include,without limitation, tartaric, diacetyltartaric, dibenzoyltartaric,ditoluoyltartaric and camphorsulfonic acid. The mixture of diastereomerscan be separated by crystallization followed by liberation of theoptically active bases from the optically active salts. An alternativeprocess for separation of optical isomers includes the use of a chiralchromatography column optimally chosen to maximize the separation of theenantiomers. Still another available method involves synthesis ofcovalent diastereoisomeric molecules by treating compounds of theinvention with an optically pure acid in an activated form or anoptically pure isocyanate. The synthesized diastereoisomers can beseparated by conventional means such as chromatography, distillation,crystallization or sublimation, and then hydrolyzed to obtain theenantiomerically pure compound. The optically active compounds of theinvention can likewise be obtained by utilizing optically activestarting materials. These isomers may be in the form of a free acid, afree base, an ester or a salt.

The invention also embraces isolated compounds. An isolated compoundrefers to a compound which represents at least 10%, such as at least20%, such as at least 50% and further such as at least 80% of thecompound present in the mixture. In one embodiment, the compound, apharmaceutically acceptable salt thereof, or a pharmaceuticalcomposition comprising the compound exhibits detectable (i.e.statistically significant) activity when tested in conventionalbiological assays such as those described herein.

3-Lactamase Inhibitors (BLIs)

In one aspect, the invention provides compounds of Formula I orpharmaceutically-acceptable salts thereof:

The substituent Z of Formula I is selected from a 1,2,4-oxadiazole or a1,2,4-thiadiazole. In one aspect of the invention the substituent

is selected from

wherein X is as described previously. In another embodiment of theinvention,

is selected from

Substituent R of Formula I is selected from

In a preferred embodiment, R is

The group R¹ is selected from:

-   -   a. hydrogen,

-   -   b.        -   wherein R² is selected from

-   -   -   wherein each of R³, R⁴ and R⁵ is independently selected from            hydrogen, (C₁-C₃)-alkyl, aminoalkyl, aminocycloalkyl, or            hydroxyalkyl, and n is selected from 1, 2 or 3,

    -   c. amino,

    -   d.

-   -   -   wherein R⁶ is selected from H, (C₁-C₃)-unsubstituted alkyl,            amino-(C₂-C₃)-alkyl, aminocycloalkyl, hydroxyalkyl,

-   -   -   and each of p and q is independently selected from 1 or 2;            and

    -   e. —CH₂(R⁷)CH₂NH₂        -   wherein R⁷ is selected from amino or hydroxyl.

In one aspect of the invention n is 1. In another aspect of theinvention n is 2. In another aspect of the invention n is 3.

In one aspect of the invention R¹ is selected from H, NH₂, or.

In one embodiment of the invention, the compounds of the invention areof the stereochemistry disclosed in Formula II.

In another embodiment of the invention, Z, R and R¹ are chosen from thesubstituents listed in Table I (See Figure I)

Preferred compounds of Formula I are the compounds:

It will be understood by one of skill in the art that depending on thenature of R¹ and R, compounds of Formula I may exist in a salt orzwitterionic form.

Enzyme Inhibition and Binding Affinity

The compounds of Formula I are effective in inhibiting β-lactamase. Whenused in combination with β-lactam antibiotics, the compounds of FormulaI potentiate the activity of the β-lactam antibiotic againstmicroorganisms that are normally resistant to β-lactam antibiotics dueto the presence of a β-lactamase or multiple β-lactamases.

In one aspect of the invention the compounds of Formula I inhibitβ-lactamases selected from class A, class C or class D β-lactamases.Class A β-lactamases for example, include, but are not limited to, TEM,SHV, CTX-M, KPC, GES, VEB, SME, and GEX. In a preferred aspect of theinvention, the compounds of the invention inhibit KPC β-lactamases. Morepreferably the compounds of the invention inhibit KPC-2 or KPC-3β-lactamases. In one aspect of the invention, the compounds of Formula Iinhibit KPC-2 or KPC-3 β-lactamases in clinical strains (FIG. 2, TableII). Class C β-lactamases for example, include, but are not limited tochromosomal AmpCs, and plasmid based ACC, DHA, CMY, FOX, ACT, MIR, LAT,MOX β-lactamases. Class D β-lactamase enzymes, for example, include, butare not limited to oxacillinases or OXA β-lactamases.

Unless otherwise indicated, the activity of the BLI compounds can bedescribed by the MIC value obtained from a Synergy MIC assay or a BLIpotentiation assay (e.g as described herein), both of which are run inthe presence a β-lactam. The lower the sMIC or MIC value the more activethe BLI, regardless of the mechanism of action of the BLI compound(e.g., including inhibition of β-lactamases by the BLI or any othermechanism of action or combination of mechanisms of action). The sMICand BLI potentiation assay data supports that the compounds of Formula Ipotentiate (i.e. make more potent) the activity of the β-lactamantibiotic against β-lactamase producing strains by inhibiting theβ-lactamase.

In one embodiment, the BLI activity is measured by growth inhibition ofa β-lactamase producing bacterial strains in a Synergy MIC (sMIC) assay.Preferably, sMIC is 8 μg/mL or less. In a more preferred aspect of theinvention, the sMIC is 4 μg/mL to 8 μg/mL. In an even more preferredaspect of the invention, the ssMIC is 1 to 2 μg/mL. In a still morepreferred aspect of the invention, the sMIC is 0.2 to 0.5 μg/mL. SynergyMICs for representative compounds of the invention are described inTable III (See FIG. 3). It will be understood by one of skill in the artthat the growth inhibition of β-lactamase producing strains can also bemeasured by a checkerboard synergy assay like that disclosed inInternational Patent Application Number WO 2008/039420 or a standard BLIpotentiation assay using a fixed concentration of BLI. In oneembodiment, the BLI activity is measured by growth inhibition of aβ-lactamase producing bacterial strains in a standard BLI potentiationassay using a fixed concentration of BLI. Preferably, the MIC is 8 μg/mLor less. In a more preferred aspect of the invention, the MIC is 4 to 8μg/mL. In an even more preferred aspect of the invention, the MIC is 1to 2 μg/mL. In a still more preferred aspect of the invention, the MICis 0.2 to 0.5 μg/mL.

The compounds of the present invention have a broad spectrum of activityacross a wide variety of β-lactamase producing bacteria. It wassurprisingly found that the compounds of the present invention areactive in potentiating activity of β-lactam antibiotics, in particular,Ceftolozane, against strains expressing class D β-lactamases, inparticular the OXA-15 β-lactamase. Currently marketed BLIs inhibit mostof the class A β-lactamases, but poorly inhibit class A KPC β-lactamasesand class C β-lactamases and have variable success in inhibitingpenicillinase and carbapenemase-type class D β-lactamases. The compoundsof the present invention are active against a wide variety of bacterialstrains that express class A and C β-lactamases and also, surprisinglyare active against bacterial strains that express the class Dcephalosporinase OXA-15 (Tables II and III). This increased activityagainst the class D β-lactamase is critical because differentialeffectiveness against different types of β-lactamase producing bacteriais necessary in order to effectively use β-lactam antibiotics to treatresistant strains of bacteria (vide infra).

In one embodiment, the compounds of Formula I are unexpectedly moreactive against bacterial strains that express OXA-15 β-lactamases thanthe most structurally similar compound, Avibactam (comparator compoundCCC). Compounds that are more active than Avibactam are, for example,compounds 801, 802, 804, and 805.

In one embodiment, the compounds of Formula I are unexpectedly moreactive against and/or show broader spectrum of activity againstbacterial strains that express KPC β-lactamases than the moststructurally similar compound, Avibactam. Compounds that are more activethan, and/or show a better spectrum of activity than Avibactam are, forexample, compounds 801, 802, 804, and 805.

In another aspect of the invention, the compounds of Formula I havehigher binding affinity for the β-lactamase enzyme. Consequently thesecompounds are better inhibitors of the β-lactamase enzyme. Theinhibition kinetics of the compounds of Formula I was measured accordingto the procedure outlined in Example 14. The compounds of Formula I havea high binding affinity for the β-lactamase enzyme.

In one embodiment the compounds of Formula I have a binding affinity of1000-5000 mM⁻¹s⁻¹.

In one embodiment the compounds of Formula I have a binding affinity of100-999 mM⁻¹s⁻¹. Compounds that have a binding affinity of 100-999 mM⁻¹s⁻¹ are, for example, compounds 801, 802, 804, 805, and 806 (Table IV).

In one embodiment the compounds of Formula I have a binding affinity of1-99 mM⁻¹s⁻¹.

It was surprisingly found that the compounds of the present inventionhave a higher binding affinity for the β-lactamase enzyme than theclosest structural comparator Avibactam (Table IV, See FIG. 4).

Pharmaceutical Compositions Comprising the Compounds of Formula I andUse Thereof

Another object of the invention is pharmaceutical compositions orformulations comprising compounds of Formula I, or salts thereof,preferably further comprising a β-lactam antibiotic.

The pharmaceutical compositions can be formulated for oral, intravenous,intramuscular, subcutaneous or parenteral administration for thetherapeutic or prophylactic treatment of diseases, such as bacterialinfections. Preferably, the pharmaceutical composition is formulated forintravenous administration.

The pharmaceutical preparations disclosed herein may be prepared inaccordance with standard procedures and are administered at dosages thatare selected to reduce, prevent or eliminate infection (see, e.g.,Remington's Pharmaceutical Sciences, Mack Publishing Company, Easton,Pa. and Goodman and Gilman's “The Pharmaceutical Basis of Therapeutics,”Pergamon Press, New York, N.Y., the contents of which are incorporatedherein by reference, for a general description of the methods foradministering various antimicrobial agents for human therapy).

The pharmaceutical compositions can comprise one or more of thecompounds disclosed herein, preferably a compound of Formula I inconjunction with a β-lactam antibiotic, in association with one or morenontoxic, pharmaceutically-acceptable carriers and/or diluents and/oradjuvants and/or excipients. As used herein, the phrase“pharmaceutically-acceptable carrier” refers to any and all solvents,dispersion media, coatings, antibacterial and antifungal agents,isotonic and absorption delaying agents, and the like, that arecompatible with pharmaceutical administration. The use of such media andagents for pharmaceutically active substances is well known in the art.Non-limiting examples of carriers and excipients include corn starch orgelatin, lactose, sucrose, microcrystalline cellulose, kaolin, mannitol,dicalcium phosphate, sodium chloride and alginic acid. The compositionsmay contain croscarmellose sodium, microcrystalline cellulose, cornstarch, sodium starch glycolate and alginic acid.

Tablet binders that can be included are acacia, methylcellulose, sodiumcarboxymethylcellulose, polyvinylpyrrolidone (Povidone), hydroxypropylmethylcellulose, sucrose, starch and ethylcellulose.

Lubricants that can be used include magnesium stearate or other metallicstearates, stearic acid, silicone fluid, talc, waxes, oils and colloidalsilica.

Flavoring agents such as peppermint, oil of wintergreen, cherryflavoring or the like can also be used. It may also be desirable to adda coloring agent to make the dosage form more aesthetic in appearance orto help identify the product.

For oral or parenteral administration, compounds of the presentinvention preferably a compound of Formula I in conjunction with aβ-lactam antibiotic, can be mixed with conventional pharmaceuticalcarriers and excipients and used in the form of tablets, capsules,elixirs, suspensions, syrups, wafers and the like. The compositionscomprising a compound of this invention may contain from about 0.1% toabout 99% by weight of the active compound, such as from about 10% toabout 30%.

For oral use, solid formulations such as tablets and capsules areuseful. Sustained release or enterically coated preparations may also bedevised. For pediatric and geriatric applications, one embodimentprovides suspensions, syrups and chewable tablets. For oraladministration, the pharmaceutical compositions are in the form of, forexample, a tablet, capsule, suspension or liquid.

The pharmaceutical compositions may be made in the form of a dosage unitcontaining a therapeutically-effective amount of the active ingredient.Examples of such dosage units are tablets and capsules. For therapeuticpurposes, the tablets and capsules which can contain, in addition to theactive ingredient, conventional carriers such as binding agents, forexample, acacia gum, gelatin, polyvinylpyrrolidone, sorbitol, ortragacanth; fillers, for example, calcium phosphate, glycine, lactose,maize-starch, sorbitol, or sucrose; lubricants, for example, magnesiumstearate, polyethylene glycol, silica, or talc; disintegrants, forexample, potato starch, flavoring or coloring agents, or acceptablewetting agents. Oral liquid preparations generally are in the form ofaqueous or oily solutions, suspensions, emulsions, syrups or elixirs,preparations of the invention may contain conventional additives such assuspending agents, emulsifying agents, non-aqueous agents,preservatives, coloring agents and flavoring agents. Non-limitingexamples of additives for liquid preparations include acacia, almondoil, ethyl alcohol, fractionated coconut oil, gelatin, glucose syrup,glycerin, hydrogenated edible fats, lecithin, methyl cellulose, methylor propyl para-hydroxybenzoate, propylene glycol, sorbitol, or sorbicacid.

For intravenous (IV) use, the pharmaceutical composition, preferably acompound of Formula I in conjunction with a β-lactam antibiotic, can bedissolved or suspended in any of the commonly used intravenous fluidsand administered by infusion. Intravenous fluids include, withoutlimitation, physiological saline or Ringer's solution. Intravenousadministration may be accomplished by using, without limitation,syringe, mini-pump or intravenous line.

Pharmaceutical compositions of this invention for parenteral injectioncomprise pharmaceutically-acceptable aqueous or non-aqueous solutions,dispersions, suspensions or emulsions as well as sterile powders forreconstitution into sterile injectable solutions or dispersions justprior to use. Examples of suitable aqueous and non-aqueous carriers,diluents, solvents or vehicles include water, ethanol, benzyl alcohol,polyols (such as glycerol, propylene glycol, and polyethylene glycol),and suitable mixtures thereof, vegetable oils (such as corn oil or oliveoil), and injectable organic esters such as ethyl oleate. Properfluidity can be maintained, for example, by the use of coating materialssuch as lecithin, by the maintenance of the required particle size inthe case of dispersions, and by the use of surfactants. The compositionscan include various buffers.

These compositions may also contain adjuvants such as preservatives,wetting agents, emulsifying agents, and dispersing agents. They may alsocontain taggants or other anti-counterfeiting agents, which are wellknown in the art. Prevention of the action of microorganisms may beensured by the inclusion of various antibacterial and antifungal agents,for example, paraben, chlorobutanol, and phenol sorbic acid. It may alsobe desirable to include isotonic agents such as sugars and sodiumchloride. Prolonged absorption of the injectable pharmaceutical form maybe brought about by the inclusion of agents which delay absorption, suchas aluminum monostearate and gelatin.

Injectable depot forms can be made by forming microencapsulatingmatrices of the drug in biodegradable polymers such aspolylactide-polyglycolide. Depending upon the ratio of drug to polymerand the nature of the particular polymer employed, the rate of drugrelease can be controlled. Examples of other biodegradable polymersinclude poly(orthoesters) and poly(anhydrides). Depot injectableformulations can also be prepared by entrapping the drug in liposomes ormicroemulsions, which are compatible with body tissues.

The injectable formulations can be sterilized, for example, byfiltration through a bacterial-retaining filter, or by incorporatingsterilizing agents in the form of sterile solid compositions, which canbe dissolved or dispersed in sterile water or other sterile injectablemedium just prior to use.

Solid dosage forms for oral administration include capsules, tablets,pills, powders, and granules. Such forms may include forms that dissolveor disintegrate quickly in the oral environment. In such solid dosageforms, the active compound preferably a compound of Formula I inconjunction with a β-lactam antibiotic, can be mixed with at least oneinert, pharmaceutically-acceptable excipient or carrier. Suitableexcipients include, for example, (a) fillers or extenders such asstarches, lactose, sucrose, glucose, mannitol, and silicic acid; (b)binders such as cellulose and cellulose derivatives (such ashydroxypropylmethylcellulose, hydroxypropylcellulose, andcarboxymethylcellulose), alginates, gelatin, polyvinylpyrrolidone,sucrose, and acacia; (c) humectants such as glycerol; (d) disintegratingagents such as sodium starch glycolate, croscarmellose, agar-agar,calcium carbonate, potato or tapioca starch, alginic acid, certainsilicates, and sodium carbonate; (e) solution retarding agents such asparaffin; (f) absorption accelerators such as quaternary ammoniumcompounds; (g) wetting agents, such as cetyl alcohol and glycerolmonostearate, fatty acid esters of sorbitan, poloxamers, andpolyethylene glycols; (h) absorbents such as kaolin and bentonite clay;(i) lubricants such as talc, calcium stearate, magnesium stearate, solidpolyethylene glycols, sodium lauryl sulfate, and mixtures thereof; and(j) glidants such as talc, and silicone dioxide. Other suitableexcipients include, for example, sodium citrate or dicalcium phosphate.The dosage forms may also comprise buffering agents.

Solid dosage forms, including those of tablets, dragees, capsules,pills, and granules, can be prepared with coatings and shells such asfunctional and aesthetic enteric coatings and other coatings well knownin the pharmaceutical formulating art. They may optionally containopacifying agents and colorants. They may also be in a form capable ofcontrolled or sustained release. Examples of embedding compositions thatcan be used for such purposes include polymeric substances and waxes.

The pharmaceutical compositions can be delivered using controlled (e.g.,capsules) or sustained release (e.g., bioerodable matrices) deliverysystems. Exemplary delayed release delivery systems for drug deliverythat are suitable for administering the pharmaceutical compositions aredescribed in U.S. Pat. No. 4,452,775 (issued to Kent), U.S. Pat. No.5,039,660 (issued to Leonard), and U.S. Pat. No. 3,854,480 (issued toZaffaroni).

In some cases, in order to prolong the effect of the drug, it may bedesirable to slow the absorption of the drug following subcutaneous orintramuscular injection. This may be accomplished by the use of a liquidsuspension of crystalline or amorphous material with poor watersolubility. Amorphous material may be used alone or together withstabilizers as necessary. The rate of absorption of the drug thendepends upon its rate of dissolution, which in turn, may depend uponcrystal size and crystalline form.

Alternatively, delayed absorption of a parenterally administered drugform can be accomplished by dissolving or suspending the drug in an oilvehicle.

For intramuscular preparations, a sterile formulation of compounds,preferably a compound of Formula I in conjunction with a β-lactamantibiotic, or suitable soluble salt forms thereof, for examplehydrochloride salts, can be dissolved and administered in apharmaceutical diluent such as Water-for-Injection (WFI), physiologicalsaline or 5% glucose. A suitable insoluble form of the compound may beprepared and administered as a suspension in an aqueous base or apharmaceutically acceptable oil base, e.g., an ester of a long chainfatty acid such as ethyl oleate.

A dose of an intravenous, intramuscular, or parental formulation ofcompounds, preferably a compound of Formula I in conjunction with aβ-lactam antibiotic, may be administered as a bolus or by slow infusion.A bolus is a dose that is administered in less than 30 minutes. In oneembodiment, a bolus is administered in less than 15 or less than 10minutes. In another embodiment, a bolus is administered in less than 5minutes. In yet another embodiment, a bolus is administered in oneminute or less. An infusion is a dose that is administered at a rate of30 minutes or greater. In one embodiment, the infusion is one hour orgreater. In another embodiment, the infusion is substantially constant.

For topical use the pharmaceutical compositions, preferably a compoundof Formula I in conjunction with a β-lactam antibiotic, can also beprepared in suitable forms to be applied to the skin, or mucus membranesof the nose and throat, and can take the form of creams, ointments,liquid sprays or inhalants, lozenges, or throat paints. Such topicalformulations further can include chemical compounds such asdimethylsulfoxide (DMSO) to facilitate surface penetration of the activeingredient.

For application to the eyes or ears, the pharmaceutical composition canbe presented in liquid or semi-liquid form formulated in hydrophobic orhydrophilic bases as ointments, creams, lotions, paints or powders.

For rectal administration, the pharmaceutical compositions, preferably acompound of Formula I in conjunction with a β-lactam antibiotic, can beadministered in the form of suppositories admixed with conventionalcarriers such as cocoa butter, polyethylene glycol or a suppository waxor other glyceride that are solid at room temperature but liquid at bodytemperature and therefore melt in the rectum or vaginal cavity andrelease the active compound.

Alternatively, the pharmaceutical compositions can be in powder form forreconstitution in the appropriate pharmaceutically acceptable carrier atthe time of delivery. In another embodiment, the unit dosage form ofcompounds, preferably a compound of Formula I in conjunction with aβ-lactam antibiotic, can be a solution of one or more compounds, orsalts thereof, in a suitable diluent, in sterile hermetically sealedampoules or sterile syringes. The concentration of the compounds,preferably a compound of Formula I in conjunction with a β-lactamantibiotic, in the unit dosage may vary, e.g. from about 1 percent toabout 50 percent, depending on the compound used and its solubility andthe dose desired by the physician. If the compositions contain dosageunits, each dosage unit can contain from 1-500 mg of the activematerial. For adult human treatment, the dosage employed can range from5 mg to 10 g, per day, depending on the route and frequency ofadministration.

The pharmaceutical compositions disclosed herein can be placed in apharmaceutically acceptable carrier and are delivered to a recipientsubject (e.g., a human) in accordance with known methods of drugdelivery. In general, the methods of delivering the pharmaceuticalcompositions in vivo utilize ar-recognized protocols for delivering theagent with the only substantial procedural modification being thesubstitution of the compounds of the present invention for the drugs inthe art-recognized protocols. Likewise, methods for using the claimedcompositions for treating cells in culture, for example, to eliminate orreduce the level of bacterial contamination of a cell culture, utilizeart-recognized protocols for treating cell cultures with antibacterialagent(s) with the only substantial procedural modification being thesubstitution of the compounds of the present invention, preferably incombination with a β-lactam antibiotic for the drugs in theart-recognized protocols.

Exemplary procedures for delivering an antibacterial agent are describedin U.S. Pat. Nos. 6,468,967; 6,852,689; and 5,041,567, issued to Rogersand in PCT patent application number EP94/02552 (publication no. WO95/05384), the disclosures of which are incorporated herein by referencein their entirety. In one embodiment, one or more compounds of FormulaI, preferably a compound of Formula I in conjunction with a β-lactamantibiotic, or pharmaceutical compositions thereof are administeredorally, rectally or via injection (intravenous, intramuscular orsubcutaneous). In another embodiment, one or more compounds of FormulaI, preferably a compound of Formula I in conjunction with a β-lactamantibiotic, or pharmaceutical compositions thereof are administeredorally, rectally or via injection (intravenous, intramuscular orsubcutaneous) to treat an infection caused by β-lactam resistantbacteria. In another embodiment, one or more compounds of Formula I,preferably a compound of Formula I in conjunction with a β-lactamantibiotic, or pharmaceutical compositions thereof are administeredorally to treat an infection caused by β-lactamase producing bacteria.As used herein, the phrases “therapeutically-effective dose” and“therapeutically-effective amount” refer to an amount of a compound thatprevents the onset, alleviates the symptoms, stops the progression of abacterial infection, or results in another desired biological outcomesuch as, e.g., improved clinical signs or reduced/elevated levels oflymphocytes and/or antibodies. The term “treating” or “treatment” isdefined as administering, to a subject, a therapeutically-effectiveamount of one or more compounds both to prevent the occurrence of aninfection and to control or eliminate an infection. Those in need oftreatment may include individuals already having a particular medicaldisease as well as those at risk for the disease (i.e., those who arelikely to ultimately acquire the disorder). The term “subject,” as usedherein, refers to a mammal, a plant, a lower animal, or a cell culture.In one embodiment, a subject is a human or other animal patient in needof antibacterial treatment.

The term “administering” or “administration” and the like, refers toproviding the compound of Formula I to the subject in need of treatment.Preferably the subject is a mammal, more preferably a human. The presentinvention comprises administering the compound of Formula I inconjunction with a β-lactam antiobiotic. When a compound of Formula I isadministered in conjunction with a β-lactam antiobiotic, the compound ofFormula I and the β-lactam antiobiotic can be administered at the sametime or different times. When the compounds of Formula I and theβ-lactam antiobiotic are administered at the same time, they can beadministered as a single composition or pharmaceutical composition orthey can be administered separately. It is understood that when acompound of Formula I is administered in conjunction with a β-lactamantiobiotic, that the active agents can be administered in a singlecombination or in multiple combinations. For example, when administeredby IV, the compound of Formula I can be dissolved or suspended in any ofthe commonly used intravenous fluids and administered by infusion, thena β-lactam antibiotic can be dissolved or suspended in any of thecommonly used intravenous fluids and administered by infusion.Conversely the β-lactam antibiotic can be dissolved or suspended in anyof the commonly used intravenous fluids and administered by infusion,then a compound of Formula I can be dissolved or suspended in any of thecommonly used intravenous fluids and administered by infusion.Alternatively, a pharmaceutical composition comprising a compound ofFormula I and a β-lactam antibiotic can be dissolved or suspended in anyof the commonly used intravenous fluids and administered by infusion.

In one embodiment of the invention, is provided a method of treating orpreventing a bacterial infection comprising administering to a subjectin need thereof a therapeutically-effective amount of the pharmaceuticalcomposition comprising a compound of Formula I and a β-lactamantibiotic.

In one embodiment of the invention, is provided a method of treating orpreventing a bacterial infection comprising administering to a subjectin need thereof, a therapeutically-effective amount of a β-lactamantibiotic in conjunction with a compound of claim 1.

In one embodiment of the invention, is provided a method of treating orpreventing a bacterial infection in a subject comprising the steps of

-   -   a. administering to the subject a compound of Formula I; and    -   b. administering a therapeutically-effective amount of a        β-lactam antibiotic.

In one embodiment of the invention, is provided a method of treating orpreventing a bacterial infection in a subject comprising the steps of

-   -   a. administering a therapeutically-effective amount of a        β-lactam antibiotic; and    -   b. administering to the subject a compound of Formula I.

In one embodiment, the invention provides a method for treating aninfection in a subject by administering a therapeutically-effectiveamount of one or more compounds of Formula I, preferably a compound ofFormula I in conjunction with a β-lactam antibiotic, or compositionsthereof. In one embodiment, the method comprises administering to asubject in need thereof a pharmaceutical composition comprising at leastone of the compounds described herein, preferably a compound of FormulaI in conjunction with a β-lactam antibiotic. In one embodiment, thepharmaceutical composition can comprise any one of the compoundsdescribed herein as the sole active compound or in combination withanother compound, composition, or biological material. The compound maybe administered orally, parenterally, by inhalation, topically,rectally, nasally, buccally, vaginally, or by an implanted reservoir,external pump or catheter. The compound may be prepared for opthalmic oraerosolized uses. The compounds of the present invention can beadministered as an aerosol for the treatment of pneumonia or otherlung-based infections. In one embodiment, the aerosol delivery vehicleis an anhydrous or dry powder inhaler. One or more compounds of FormulaI, preferably a compound of Formula I in conjunction with a β-lactamantibiotic, or pharmaceutical compositions thereof also may be directlyinjected or administered into an abscess, ventricle or joint. Parenteraladministration includes subcutaneous, intravenous, intramuscular,intra-articular, intra-synovial, cisternal, intrathecal, intrahepatic,intralesional and intracranial injection or infusion. In one embodiment,one or more compounds of Formula I, preferably a compound of Formula Iin conjunction with a β-lactam antibiotic, are administeredintravenously, subcutaneously or orally. In one embodiment foradministering one or more compounds according to Formula I, preferably acompound of Formula I in conjunction with a β-lactam antibiotic to acell culture, the one or more compounds may be administered in anutrient medium.

In one embodiment, one or more compounds according to Formula I,preferably a compound of Formula I in conjunction with a β-lactamantibiotic, may be used to treat a subject having a bacterial infectionin which the infection is caused or exacerbated by any type of bacteria,such as Gram-negative bacteria. In one aspect of the invention, thebacterial infection is caused by β-lactam resistant bacteria. In oneaspect the bacterial infection is caused by β-lactamase producingbacteria. In another aspect the bacterial infection is caused by classA, class C or class D β-lactamase producing bacteria. In another aspectthe bacterial infection is caused by class A β-lactamase producingbacteria. In another aspect the infection is caused by class Cβ-lactamase producing bacteria. In still another aspect the infection iscaused by class D β-lactamase producing bacteria. In still anotheraspect the infection is caused by KPC β-lactamase producing bacteria. Instill another aspect the infection is caused by OXA β-lactamaseproducing bacteria.

Representative Gram-negative pathogens known to express β-lactamasesinclude, but are not limited to Acinetobacter spp. (includingAcinetobacter baumannii), Citrobacter spp., Escherichia spp. (includingEscherichia coli), Haemophilus influenzae, Morganella morganii,Pseudomonas aeruginosa, Klebsiella spp. (including Klebsiellapneumoniae), Enterobacter spp. (including Enterobacter cloacae andEnterobacter aerogenes), Pasteurella spp., Proteus spp. (includingProteus mirabilis), Serratia spp. (including Serratia marcescens), andProvidencia spp. Bacterial infections can be caused or exacerbated byGram-negative bacteria including strains which express β-lactamases thatmay confer resistance to penicillins, cephalosporins, monobactams and/orcarbapenems. The co-administration of a novel BLIs that inhibits theseβ-lactamases with a β-lactam antibiotic could be used to treatinfections caused β-lactam resistant bacteria.

In one aspect of the invention the infection is caused by a β-lactamaseproducing bacteria selected from Acinetobacter spp, Citrobacter spp,Escherichia coli, Enterobacter cloacae), Haemophilus influenzae,Pseudomonas aeruginosa, Proteus mirabilis, Serratia marcescens, andKlebsiella pneumoniae,

β-Lactam antibiotics that may be co-administered with compounds ofFormula I include, but are not limited to cephalosporin, carbapenem,monobactam, penem and penicillin classes of antibiotics.

In one embodiment of the invention, the β-lactam antibiotic is acephalosporin. Examples of cephalosporins include, but are not limitedto, Cefacetrile (cephacetrile), Cefadroxil (cefadroxyl), Cefalexin(cephalexin), Cefaloglycin (cephaloglycin), Cefalonium (cephalonium),Cefaloridine (cephaloradine), Cefalotin (cephalothin), Cefapirin(cephapirin), Cefatrizine, Cefazaflur, Cefazedone, Cefazolin(cephazolin), Cefradine (cephradine), Cefroxadine, Ceftezole, Cefaclor,Cefamandole, Cefmetazole, Cefonicid, Cefotetan, Cefoxitin, Cefprozil(cefproxil), Cefuroxime, Cefuzonam, Cefcapene, Cefdaloxime, Cefdinir,Cefditoren, Cefetamet, Cefixime, Cefmenoxime, Cefodizime, Cefotaxime,Cefpimizole, Cefpodoxime, Cefteram, Ceftibuten, Ceftiofur, Ceftiolene,Ceftizoxime, Ceftriaxone, Cefoperazone, Ceftazidime, Cefclidine,Cefepime, Cefluprenam, Cefoselis, Cefozopran, Cefpirome, Cefquinome,Cefaclomezine, Cefaloram, Cefaparole, Cefcanel, Cefedrolor, Cefempidone,Cefetrizole, Cefivitril, Cefmatilen, Cefmepidium, Cefovecin, Cefoxazole,Cefrotil, Cefsumide, Ceftaroline, Ceftioxide, Cefuracetime,cefbuperazone, cefminox, ceforanide, cefotiam, cefpiramide, cefsulodin,ceftobiprole latamoxef, loracarbef and Ceftolozane. In one embodimentthe cephalosporin is Ceftolozane or Ceftazidime.

In one embodiment of the invention, the β-lactam antibiotic is acarbapenen. Examples of carbapenem antibiotics include, but are notlimited to, Imipenem, Imipenem/Cilastatin, Biapenem, Doripenem,Meropenem, Ertapenem and Panipenem. In one embodiment the Carbapenem isImipenem/Cilastatin or Meropenem.

In one embodiment of the invention, the β-lactam antibiotic is amonobactam. Examples of monobactam antibiotics include, but are notlimited to Aztreonam, Tigemonam, Carumonam, BAL30072 and Nocardicin A.

In one embodiment of the invention, the β-lactam antibiotic is a penem.

In one embodiment of the invention, the β-lactam antibiotic is apenicillin Examples of penicillin antibiotics include, but are notlimited to

Amoxicillin, Ampicillin, Azlocillin, Mezlocillin, Apalcillin,Hetacillin, Becampicillin, Carbenicillin, Sulbenicillin, Ticarcillin,Piperacillin, Azlocillin, Mecillinam, Pivmecillinam, Methicillin,Ciclacillin, Talampicillin, Aspoxicillin, Oxacillin, Cloxacillin,Dicloxacillin, Flucloxacillin, Nafcillin and Pivampicillin.

The pharmaceutical compositions, preferably a compound of Formula I inconjunction with a β-lactam antibiotic, can be used to treat a bacterialinfection of any organ or tissue in the body caused by β-lactamresistant bacteria, preferably, Gram-negative β-lactam resistantbacteria. These organs or tissue include, without limitation, skeletalmuscle, skin, bloodstream, kidneys, heart, lung and bone. For example, apharmaceutical composition comprising at least one compound of Formula(I), preferably a compound of Formula I in conjunction with a β-lactamantibiotic, can be administered to a subject to treat, withoutlimitation, skin and soft tissue infections (e.g., complex skininfections), bacteremia, intra-abdominal infections and urinary tractinfections (e.g., cUTI). In addition, a compound of Formula (I) may beused to treat community acquired respiratory infections, including,without limitation, otitis media, sinusitis, chronic bronchitis andpneumonia (including community-acquired pneumonia, hospital-acquiredpneumonia and ventilator associated pneumonia), including pneumoniacaused by drug-resistant Pseudomonas aeruginosa. At least one compoundof Formula (I), preferably a compound of Formula I in conjunction with aβ-lactam antibiotic, can be administered to a subject to treat mixedinfections that comprise different types of Gram-negative bacteria, orwhich comprise both Gram-positive and Gram-negative bacteria. Thesetypes of infections include intra-abdominal infections andobstetrical/gynecological infections. At least one compound of Formula(I), preferably a compound of Formula I in conjunction with a β-lactamantibiotic, may also be administered to a subject to treat an infectionincluding, without limitation, endocarditis, nephritis, septicarthritis, intra-abdominal sepsis, bone and joint infections andosteomyelitis. At least one compound of Formula (I), preferably compoundof Formula I in conjunction with a β-lactam antibiotic, orpharmaceutical compositions thereof, may also be directly injected oradministered into an abscess, ventricle or joint. Pharmaceuticalcompositions administered as an aerosol for the treatment of pneumoniaor other lung-based infections. In one embodiment, the aerosol deliveryvehicle is an anhydrous, liquid or dry powder inhaler.

Actual dosage levels of active ingredients in the pharmaceuticalcompositions of one or more compounds according to Formula I, preferablya compound of Formula I in conjunction with a β-lactam antibiotic, maybe varied so as to obtain a therapeutically-effective amount of theactive compound(s) to achieve the desired therapeutic response for aparticular patient, compositions, and mode of administration. Theeffective amount can be determined as described herein. The selecteddosage level will depend upon the activity of the particular compound,the route of administration, the severity of the condition beingtreated, and the condition and prior medical history of the patientbeing treated. However, it is within the skill of the art to start dosesof the compound at levels lower than required to achieve the desiredtherapeutic effect and to gradually increase the dosage until thedesired effect is achieved. In one embodiment, the data obtained fromthe assays can be used in formulating a range of dosage for use inhumans. It will be understood by one of skill in the art that the whenthe composition comprises a compound of Formula I and a β-lactamantibiotic, both the compound of Formula I and the β-lactam antibioticare active compounds.

The method comprises administering to the subject an effective dose ofone or more compounds of Formula I, preferably in conjunction with a βlactam antibiotic. An effective dose of a compound of Formula I isgenerally between 125 mg/day to 2000 mg/day. In one embodiment, aneffective dose is from about 0.1 to about 100 mg/kg of one or morecompounds of Formula I or pharmaceutically acceptable salts thereof. Inone embodiment, the dose is from about 0.1 to about 50 mg/kg of one ormore compounds of Formula I or pharmaceutically acceptable saltsthereof. In another embodiment, the dose is from about 1 to about 25mg/kg of one or more compounds of Formula I or pharmaceuticallyacceptable salts thereof. In another embodiment, the dose is from about1 to about 12 mg/kg of one or more compounds of Formula I. In anotherembodiment, the dose is about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12mg/kg of one or more compounds of Formula I. In another embodiment, thecompounds of Formula I are administered to a human at a dose of 100 mgto 1000 mg per dose up to four times per day. In another embodiment, thecompounds of Formula I are administered to a human at a dose of 125 mgto 750 mg per dose up to four times per day. In another embodiment, thecompounds of Formula I are administered to a human at a dose of 250 mgto 500 mg per dose up to four times a day. An effective dose for cellculture is usually between about 0.1 and about 1000 μg/mL. In oneembodiment, the effect dose for cell culture is between about 0.1 andabout 200 μg/mL.

In one embodiment, a β-lactam antibiotic and a compound of Formula I areadministered in ratio of 1:4 to 8:1 antibiotic:Formula 1 compound. Inone embodiment the ratio is 1:4. In another embodiment the ratio is 3:4.In another embodiment the ratio is 5:4. In another embodiment the ratiois 7:4. In another embodiment the ratio is 1:2. In another embodimentthe ratio is 3:2. In another embodiment the ratio is 5:2. In anotherembodiment the ratio is 7:2. In another embodiment the ratio is 1:3. Inanother embodiment the ratio is 2:3. In another embodiment the ratio is4:3. In another embodiment the ratio is 5:3. In another embodiment theratio is 7:3. In another embodiment the ratio is 1:2. In anotherembodiment the ratio is 3:2. In another embodiment the ratio is 5:2. Inanother embodiment the ratio is 7:2. In another embodiment the ratio is1:1. In another embodiment the ratio is 2:1. In another embodiment theratio is 3:1. In another embodiment the ratio is 4:1. In anotherembodiment the ratio is 5:1. In another embodiment the ratio is 6:1. Inanother embodiment the ratio is 7:1. In another embodiment the ratio is8:1. It will be understood by one of skill in the art that the β-lactamantibiotic and compound of Formula I can be administered within therange of ratios provided regardless of the method of drug delivery. Itwill also be understood by one of skill in the art that the β-lactamantibiotic and compound of Formula I can be administered within therange of ratios provided together, for example, in a pharmaceuticalcomposition, or sequentially, i.e. the β-lactam antibiotic isadministered, followed by administration of a compound of Formula I orvice versa.

One or more compounds of Formula I may also be administered in the dietor feed of a patient or animal. If administered as part of a totaldietary intake, the amount of compound employed can be less than 1% byweight of the diet, such as no more than 0.5% by weight. The diet foranimals can be normal foodstuffs to which the compound can be added orit can be added to a premix.

One or more compounds of Formula I, preferably a compound of Formula Iin conjunction with a β-lactam antibiotic, can be administered as asingle daily dose or in multiple doses per day. In one embodiment, oneor more compounds of Formula I, preferably a compound of Formula I inconjunction with a β-lactam antibiotic, is administered as a single doseper day. In another embodiment, one or more compounds of Formula I,preferably a compound of Formula I in conjunction with a β-lactamantibiotic is administered as two equal doses per day. In anotherembodiment, the compounds of Formula I, preferably a compound of FormulaI in conjunction with a β-lactam antibiotic is administered in threeequal doses per day. In another embodiment, the compounds of Formula I,preferably a compound of Formula I in conjunction with a β-lactamantibiotic is administered in four equal doses per day. The treatmentregime may require administration over extended periods of time, e.g.,for several days or for from two to four weeks. The amount peradministered dose or the total amount administered will depend on suchfactors as the nature and severity of the infection, the age and generalhealth of the patient, the tolerance of the patient to the compound andthe microorganism or microorganisms involved in the infection. Thetreatment regimen for one type of infection may differ greatly from thetreatment regimen of another infection. For example, one type ofinfection may require administration via intravenous administration oncedaily, while another infection may require a treatment regimen ofmultiple dosing orally.

One or more compounds of Formula I, preferably a compound of Formula Iin conjunction with a β-lactam antibiotic, may be administered accordingto this method until the bacterial infection is eradicated or reduced.In one embodiment, one or more compounds of Formula I, preferably acompound of Formula I in conjunction with a β-lactam antibiotic, areadministered for a period of time from 3 days to 6 months. In anotherembodiment, one or more compounds of Formula I, preferably a compound ofFormula I in conjunction with a β-lactam antibiotic, are administeredfor 7 to 56 days. In another embodiment, one or more compounds ofFormula I, preferably a compound of Formula I in conjunction with aβ-lactam antibiotic, are administered for 7 to 28 days. In a furtherembodiment, one or more compounds of Formula I, preferably a compound ofFormula I in conjunction with a β-lactam antibiotic, are administeredfor 7 to 14 days. Compounds of the present invention may be administeredfor a longer or shorter time period if it is so desired.

Other embodiments of the invention include:

A pharmaceutical composition comprising a compound of Formula I and atleast 1 β-lactam antibiotic or a pharmaceutically acceptable saltthereof.

A pharmaceutical composition comprising a compound of Formula I and atleast 1 cephalosporin antibiotic or a pharmaceutically acceptable saltthereof.

A pharmaceutical composition comprising a compound of Formula I andCeftolozane antibiotic or a pharmaceutically acceptable salt thereof.

A pharmaceutical composition comprising a compound of Formula I and atleast 1 carbapenem antibiotic or a pharmaceutically acceptable saltthereof.

A pharmaceutical composition comprising a compound of Formula I and atleast 1 monobactam antibiotic or a pharmaceutically acceptable saltthereof.

The embodiments described herein provide compounds of Formula I that arenovel and active β-lactamase inhibitors. Other embodiments describedherein provide novel compounds of Formula I in conjunction with β-lactamantibiotics for treatment of infections. Further embodiments describedherein provide novel compounds of Formula I that show unexpectedactivity against β-lactamases that other compounds in the class do nothave.

Other embodiments of the invention will be apparent to those skilled inthe art from consideration of the specification and practice of theinvention disclosed herein. It is intended that the specification andexamples be considered as exemplary only, with the true scope and spiritof the invention being indicated by the following claims.

Preparation of Compounds of Formula I

A compound of formula (I) can be prepared by a variety of syntheticroutes, including synthetic schemes described herein. These syntheticroutes can be applied to large scale synthesis with appropriateadjustment of reaction sequence, reaction conditions,isolation/purification methods and choice of solvents which areenvironmentally friendly and cost-effective.

The following abbreviations have the following meanings unless otherwiseindicated. Abbreviations not defined below have their generally acceptedmeaning.

-   -   Bn=benzyl    -   Boc=tert-butoxycarbonyl    -   Boc₂O=di-tert-butyldicarbonate    -   Burgess reagent=methyl N-triethylammoniumsulfonyl)carbamate    -   CDI=carbonyldiimidazole    -   CFU=colony-forming units    -   CLSI=Clinical Laboratory Standards Institute    -   cSSSI=complicated skin and skin structure infections    -   DBU=1,8-diazabicyclo[5.4.0]undec-7-ene    -   DCM=dichloromethane    -   DEAD=diethyl azodicarboxylate    -   DIAD=diisopropyl azodicarboxylate    -   DIPEA=diisopropylethylamine    -   DMF=N,N-dimethylformamide    -   DMAc=N,N-dimethylacetamide    -   DMSO=dimethyl sulfoxide    -   EDCI=1-ethyl-3-(3′-dimethylaminopropyl)carbodiimide    -   ELSD=evaporative light scattering detector    -   EtOAc=ethyl acetate    -   ESI-MS=electrospray ionization mass spectrometry    -   Fmoc=Fluorenylmethyloxycarbonyl    -   HAP=Hospital-Acquired Pneumonia    -   HATU=2-(7-aza-1H-benzotriazole-1-yl)-1,1,3,3-tetramethyluronium        hexafluorophosphate    -   HCl=hydrochloride    -   HOBt=1-hydroxybenzotrizole    -   Hrs=hours    -   HPLC=high performance liquid chromatography    -   Hunig's base=N,N-Diisopropylethylamine    -   Lawesson's        reagent=2,4-bis(4-methoxyphenyl)-1,3,2,4-dithiadiphosphetane-2,4-disulfide    -   MIC=minimum inhibitory concentration    -   mL=milliliter    -   MS=mass spectrometry    -   MRSA=methicillin-resistant Staphylococcus aureus    -   NMR=nuclear magnetic resonance    -   Ns=nitrobenzenesulfonyl    -   Pa=Pseudomonas aeruginosa    -   Prep=preparative    -   Ppm=parts per million    -   sat.=saturated    -   rt=room temperature    -   TBAF=tetrabutylammonium fluride    -   TBS=t-butyldimethylsilyl    -   TES=triethylsilyl    -   TEA=triethylamine    -   TEMPO=2,2,6,6-tetramethyl-1-piperidinyloxy, free radical    -   THF=tetrahydrofuran    -   TFA=trifluoroacetic acid    -   TMS=trimethylsilyl    -   TLC=thin layer chromatography    -   VAP=Ventilator-Associated Pneumonia

The compounds of Formula (I) can be prepared from intermediate 1 or 7,according to the following reaction schemes and examples, ormodifications thereof, using readily available starting materials,reagents and conventional synthetic procedures including, for example,procedures described in U.S. Pat. No. 7,112,592 and WO2009/091856. Asdepicted in Scheme 1, compound 3 can be synthesized following standardheterocyclic ring formation chemistry under appropriate reactionconditions from ester intermediate 1, or its corresponding derivatives,such as carboxylic acid derivative 2a and aldehyde derivative 2b (see,e.g., Jakopin, Z.; Dolenc, M. S. Curr. Org. Chem. 2008, 12, 850-898,hereafter Jakopin; Walker, D. G.; Brodfuehrer, P. R.; Brundidge, S. P.Shih, K. M.; Sapino, C. Jr. J. Org. Chem. 1988, 53, 983-991 hereafterWalker and references cited therein).

It may be necessary to protect certain functionalities in the moleculedepending on the nature of the R¹ group. Protecting thesefunctionalities should be within the expertise of one skilled in theart. See, e.g. P. G. M. Wuts and T. W. Greene, Protective Groups inOrganic Synthesis, Fourth Edition, John Wiley and Sons, 2006, hereafterGreene.

Alternatively, compound 3 can be synthesized from intermediate 7 asshown in Scheme 2. Monocyclic ester intermediate 7 can be converted to 8under standard Mitsunobu reaction conditions. Compound 9 can then beprepared following standard heterocyclic ring formation chemistry underappropriate reaction conditions from ester intermediate 8, or itscorresponding derivatives (see, e.g., Jakopinand Walker and referencescited therein). Deprotection of N-Ns group in compound 9 providescompound 10, which can be converted to compound 11 by treating withdiphosgene. Compound 3 can be obtained upon deprotection of N-Boc groupfrom compound 11 under appropriate conditions, such as 4M HCl indioxane, and subsequent treatment with base, such as NEt₃.Alternatively, deprotection of N-Boc and N-Ns groups in compound 11under appropriate conditions provides bis-amine derivative 12, which canthen be cyclized to form compound 3 by treatment with diphosgene ortriphogene, under appropriate conditions.

The benzylic ether protecting group in 3 can be removed via standardhydrogenolysis conditions, such as, but not limited to, Pd/H₂ in MeOH orTHF or by acid-catalyzed hydrolysis, such as, but not limited to, BCl₃in DCM to provide the hydroxy-urea intermediate 4, which can be useddirectly in the next step without further purification. Sulfation of 4can be achieved by treatment with a sulfating reagent, such a, but notlimited to, SO₃.pyridine complex, in an appropriate solvent, such aspyridine, DMF or DMAc at a temperature of 0-80° C., preferable at roomtemperature. Compound 5 can then be isolated and purified viaconventional methods. For example, 5 can be purified by standard reversephase prep-HPLC using appropriate buffer system, i e ammonium formatebuffer. In some cases, 5 can be purified by normal phase silica gelchromatography after converting to an appropriate salt form, such assulfate tetrabutyl ammonium salt. The tetrabutyl ammonium salt can beconverted to a sodium salt by cation exchange. When protecting group(s)are present in the sidechain (i.e. Boc or Fmoc for amine and guanidineprotection, TBS or TES for alcohol protection, etc), a deprotection stepis needed to convert 5 to its final product 6, which can be purified byreverse phase prep-HPLC using the conditions mentioned above. Forexample, for N-Boc deprotection, 5 can be treated with an acid, such asTFA, in an appropriate solvent, such as DCM at a temperature of 0-30°C., preferable at 0° C. to rt to give 6. For an O-TBS, or O-TESdeprotection, a fluoride reagent such as HF.pyridine, HF.NEt₃, or TBAFcan be used. For an Fmoc deprotection, amines, such as diethylamine,DBU, piperidine, etc can be used.

EXAMPLES

The specific examples which follow illustrate the synthesis of certaincompounds. The methods disclosed may be adopted to variations in orderto produce compounds of Formula (I), but not otherwise specificallydisclosed. Further, the disclosure includes variations of the methodsdescribed herein to produce the compounds of Formula (I) that would beunderstood by one skilled in the art based on the instant disclosure.

All temperatures are understood to be in Centigrade (C) when notspecified. The nuclear magnetic resonance (NMR) spectral characteristicsrefer to chemical shifts (y) expressed in parts per million (ppm) versustetramethylsilane (TMS) as reference standard. The relative areareported for the various shifts in the proton NMR spectral datacorresponds to the number of hydrogen atoms of a particular functionaltype in the molecule. The nature of the shifts as to multiplicity isreported as broad singlet (br s), broad doublet (br d), singlet (s),multiplet (m), doublet (d), quartet (q), doublet of doublet (dd),doublet of triplet (dt), and doublet of quartet (dq). The solventsemployed for taking NMR spectra are DMSO-d6(perdeuterodimethysulfoxide), D₂O (deuterated water), CDCl₃(deuterochloroform) and other conventional deuterated solvents. Theprep-HPLC conditions are: Waters SunFire® C18 (30×100 mm, 5 μm OBD)column; flow rate: 30-80 mL/minute, ELSD or Mass-triggered fractioncollection; sample loading: Each injection loading varied from 30-300 mgfor different crude samples depending on their solubility and purityprofiles; Solvent system using ammonium formate buffer: solvent A: waterwith 20 mM ammonium formate, solvent B: 85% of acetonitrile in waterwith 20 mM ammonium formate. Solvent system using NH₄HCO₃ buffer:solvent A: water with 10 mM NH₄HCO₃, solvent B: acetonitrile. Solventsystem using NH₄OH buffer: solvent A: water with 0.1% NH₄OH, solvent B:acetonitrile with 0.1% NH₄OH.

Example 1 Synthesis of (2S,5R)-ethyl6-(benzyloxy)-7-oxo-1,6-diazabicyclo[3.2.1]octane-2-carboxylate(Intermediate Compound 1)

Step 1: Synthesis of (S)-1-tert-butyl 2-ethyl5-oxopiperidine-1,2-dicarboxylate Method A:

n-BuLi was added dropwise to a solution of TMSCHN₂ (690 mL, 1.38 mol) indry THF (3 L) (600 mL, 1.5 mol) at −78° C., and the mixture was stirredat −78° C. for 30 minutes. The mixture was then transferred to asolution of (S)-1-tert-butyl 2-ethyl 5-oxopyrrolidine-1,2-dicarboxylate(300 g, 1.17 mol) in dry THF (3 L) via cannula, and the mixture wasstirred at −78° C. for 30 minutes. The reaction mixture was thenquenched with sat. NH₄Cl solution, and extracted with DCM three times.The combined organic layer was concentrated in vacuum and the crudeproduct was purified by silica gel column chromatography (3:1 petroleumether:EtOAc) to afford (S)-ethyl2-((tert-butoxycarbonyl)amino)-6-diazo-5-oxohexanoate (262 g, 75%) as ayellow solid.

A solution of (S)-ethyl2-((tert-butoxycarbonyl)amino)-6-diazo-5-oxohexanoate (350 g, 1.18 mol)in DCM (1500 mL) was added to a solution of Rh₂(OAc)₄ (3.5 g, 7.9 mmol)in DCM (750 mL) at 0° C. The reaction was then stirred at 20° C.overnight and then concentrated in vacuum. The crude sample was purifiedby silica gel column chromatography (5:1 petroleum ether/EtOAc) toafford (S)-1-tert-butyl 2-ethyl 5-oxopiperidine-1,2-dicarboxylate (175.9g, 55%) as a yellow oil.

Method B:

t-BuOK (330 g, 2.9 mol) was added to a solution of trimethylsulfoxoniumiodide (750 g, 3.5 mol) in dry DMSO (3 L) and the mixture was stirred atrt for 1 h. (S)-1-tert-Butyl 2-ethyl 5-oxopyrrolidine-1,2-dicarboxylate(900 g, 3.5 mol) was added and the mixture was stirred at rt for 2-3hrs. Water was added to quench the reaction and the mixture wasextracted with EtOAc 5 times. The combined organic layer wasconcentrated in vacuum and the crude sample was purified by silica gelcolumn chromatography (1:1petroleum ether/EtOAc then 1:10MeOH/DCM) toafford sulfoxonium ylide intermediate (977 g, 80%) as a white solid.

A solution of sulfoxonium ylide intermediate (156 g, 0.446 mol) and[Ir(COD)Cl]₂ (3 g, 4.46 mmol) in toluene (4 L) was degassed by bubblingnitrogen through the solution for 10 minutes. The reaction mixture washeated to 80-90° C. for 2-3 hrs and then cooled to 20° C. Then toluenewas concentrated in vacuum, the residue was purified by silica gelcolumn chromatography (gradient elution 10:1 to 3:1 petroleumether/EtOAc) to afford (S)-1-tert-butyl 2-ethyl5-oxopiperidine-1,2-dicarboxylate (140 g, 57.8%) as a yellow oil.

Step 2: Synthesis of (2S,5S)-1-ten-butyl 2-ethyl5-hydroxypiperidine-1,2-dicarboxylate

NaBH₄ (36 g, 1.0 mol) was added in portions to a solution of(S)-1-tert-butyl 2-ethyl 5-oxopiperidine-1,2-dicarboxylate (250 g, 0.92mol) in EtOH (1500 mL) at −40° C. The reaction mixture was then stirredat −40° C. for 0.5 hr then quenched with 10% HOAc solution. Afterdiluting with water, the mixture was extracted with DCM three times. Thecombined organic layer was concentrated in vacuum and purified by silicagel column chromatography (1:1 petroleum ether/EtOAc) to afford(2S,5S)-1-tert-butyl 2-ethyl 5-hydroxypiperidine-1,2-dicarboxylate (205g, 80%) as a yellow oil.

Step 3: Synthesis of (2S,5R)-1-tert-butyl 2-ethyl5-(N-(benzyloxy)-2-nitrophenylsulfonamido)piperidine-1,2-dicarboxylate

A solution of 2-nitrobenzene-1-sulfonyl chloride (500 g, 2.26 mol) inpyridine (1500 mL) was added dropwise to a solution ofO-benzylhydroxylamine hydrochloride (400 g, 2.51 mol) in pyridine (1500mL) at 0° C. The reaction mixture was then stirred at 20° C. overnight.The mixture was concentrated in vacuum, diluted with DCM and washed withHCl (10%) three times. The combined organic layer was concentrated invacuum and re-crystallized with DCM to affordN-(benzyloxy)-2-nitrobenzenesulfonamide (485 g, 62.6%) as a yellowsolid.

To a solution of N-(benzyloxy)-2-nitrobenzenesulfonamide (212 g, 0.69mol) in THF (1000 mL) was added (2S,5S)-1-tert-butyl 2-ethyl5-hydroxypiperidine-1,2-dicarboxylate (171 g, 0.63 mol) and PPh₃ (275 g,1.05 mol), followed by dropwise addition of a solution of DEAD (195 g,1.12 mol) in THF (500 mL). The mixture was then stirred at 20° C.overnight. The reaction mixture was then concentrated in vacuum andpurified by silica gel column chromatography (3:1 petroleum ether/EtOAc)to afford (2S,5R)-1-tert-butyl 2-ethyl5-(N-(benzyloxy)-2-nitrophenylsulfonamido)piperidine-1,2-dicarboxylate(283.8 g, 80%) as a yellow oil.

Step 4: Synthesis of (2S,5R)-1-tert-butyl 2-ethyl5-((benzyloxy)amino)piperidine-1,2-dicarboxylate

LiOH.H₂O (95 g, 2.3 mol) and 2-mercaptoacetic acid (124 g, 1.3 mol) wereadded to a solution of (2S,5R)-1-tert-butyl 2-ethyl5-(N-(benzyloxy)-2-nitrophenylsulfonamido)piperidine-1,2-dicarboxylate(251 g, 0.45 mol) in DMF (1200 mL). The reaction mixture was thenstirred at 20° C. overnight. The reaction mixture was diluted with waterand extracted with EtOAc (3×). The combined organic layer was washedwith brine (3×), concentrated in vacuum and purified by silica gelcolumn chromatography (3:1 petroleum ether/EtOAc) to afford(2S,5R)-1-tert-butyl 2-ethyl5-((benzyloxy)amino)piperidine-1,2-dicarboxylate (122.9 g, 85%) as ayellow solid.

Step 5: Synthesis of (2S,5R)-ethyl5-((benzyloxy)amino)piperidine-2-carboxylate

TFA (600 mL) was added to a solution of (2S,5R)-1-tert-butyl 2-ethyl5-((benzyloxy)amino)piperidine-1,2-dicarboxylate (263 g, 0.7 mol) in DCM(600 mL) at 20° C. The mixture was stirred at rt overnight and thenconcentrated in vacuum. The crude product was adjusted to pH 10 withsat. NaHCO₃ solution, and then extracted with DCM three times. Thecombined organic layer was concentrated in vacuum and purified by silicagel column chromatography (20:1 DCM/MeOH) to afford (2S,5R)-ethyl5-((benzyloxy)amino)piperidine-2-carboxylate (184.9 g, 95%) as a yellowoil.

Step 6: Synthesis of (2S,5R)-ethyl6-(benzyloxy)-7-oxo-1,6-diazabicyclo[3.2.1]octane-2-carboxylate

Triphosgene (21.3 g, 72 mmol) was added in portions to a solution of(2S,5R)-ethyl 5-((benzyloxy)amino)piperidine-2-carboxylate (50 g, 0.18mol) and DIPEA (128 mL, 0.72 mol) in DCM (2000 mL) at 0° C. Afterstirring at 20° C. overnight, the reaction mixture was washed with H₃PO₄(10%), sat. NaHCO₃ and saturated NaCl. The combined organic layer wasconcentrated in vacuum and purified by silica gel column chromatography(3:1 petroleum ether/EtOAc) to afford (2S,5R)-ethyl6-(benzyloxy)-7-oxo-1,6-diazabicyclo[3.2.1]octane-2-carboxylate (27.4 g,50%) as a yellow solid. ¹H NMR (400 Mz, CDCl₃): δ 7.43-7.36 (m, 5H),5.06 (d, J=11.4 Hz, 1H), 4.90 (d, J=11.4 Hz, 1H), 4.24 (q, J=7.1 Hz,2H), 4.11-4.08 (m, 1H), 3.32-3.31 (m, 1H), 3.08-3.05 (m, 1H), 2.93 (d,J=11.9 Hz, 1H), 2.14-2.05 (m, 2H), 2.05-2.00 (m, 1H), 1.71-1.63 (m, 1H),1.29 (t, J=7.1 Hz, 3H).

Example 2 Synthesis of(2S,5R)-6-(benzyloxy)-7-oxo-1,6-diazabicyclo[3.2.1]octane-2-carboxylicacid (Intermediate Compound 2a)

LiOH (1.2 g, 29.6 mmol) was added to a solution of (2S,5R)-ethyl6-(benzyloxy)-7-oxo-1,6-diazabicyclo[3.2.1]octane-2-carboxylate (9 g,29.6 mmol) in THF/H₂O (3:1, 240 mL). The mixture was then stirred at rtovernight. The reaction mixture was washed with EtOAc twice, then theaqueous solution was adjusted pH 2-3 with 1N HCl. The resulting mixturewas extracted with DCM three times, and the combined organic layer wasdried over saturated Na₂SO₄ and concentrated in vacuum to provide(2S,5R)-6-(benzyloxy)-7-oxo-1,6-diazabicyclo[3.2.1]octane-2-carboxylicacid (7.0 g, 77.7%), which was directly used in the next step withoutfurther purification. ESI-MS (EI⁺, m/z): 277.31. ¹H NMR (300 MHz, CDCl₃)δ 7.49-7.29 (m, 5H), 5.06 (d, J=11.4 Hz, 1H), 4.91 (d, J=11.4 Hz, 1H),4.15-4.10 (m, 1H), 3.36-3.34 (m, 1H), 3.15-3.11 (m, 1H), 2.83 (d, J=11.8Hz, 1H), 2.32-2.15 (m, 1H), 2.11-2.01 (m, 2H), 1.74-1.56 (m, 1H).

Example 3 Synthesis of(2S,5R)-6-(benzyloxy)-7-oxo-1,6-diazabicyclo[3.2.1]octane-2-carbaldehyde(intermediate compound 2b)

LiBH₄ (0.54 g, 24.67 mmol) was added to a solution of (2S,5R)-ethyl6-(benzyloxy)-7-oxo-1,6-diazabicyclo[3.2.1]octane-2-carboxylate (5 g,16.44 mmol) in MeOH (50 mL) at −10° C. After 15 minutes another portionof LiBH₄ (0.54 g, 24.67 mmol) was added and the mixture was stirred at−10 to 0° C. for 4-5 h. The reaction mixture was carefully quenched byaddition of sat. NaH₂PO₄ (50 mL) at 0° C. The mixture was diluted withwater (20 mL) and extracted with DCM three times. The combined organiclayer was concentrated and purified by silica gel column chromatography(gradient elution 0-100% petroleum ether/EtOAc, then 0-2% MeOH/EtOAc) togive(2S,5R)-6-(benzyloxy)-2-(hydroxymethyl)-1,6-diazabicyclo[3.2.1]octan-7-one(3.8 g, 88%) as a white solid. ESI-MS (EI⁺, m/z): 263.1. ¹H-NMR (500M,CDCl₃): 7.44-7.35 (m, 5H), 5.05 (d, J=11.5 Hz, 1H), 4.90 (d, J=11.5 Hz,1H), 3.73-3.69 (m, 1H), 3.61-3.58 (m, 2H), 3.33 (m, 1H), 3.01 (br d,J=12.0 Hz, 1H), 2.91 (m, 1H), 2.03-1.95 (m, 2H), 1.58-1.54 (m, 1H),1.39-1.24 (m, 1H).

TEMPO (48 mg, 0.3 mmol) was added in portions to a solution of(2S,5R)-6-(benzyloxy)-2-(hydroxymethyl)-1,6-diazabicyclo[3.2.1]octan-7-one(7.8 g, 30 mmol) and 1,3,5-trichloro-1,3,5-triazinane-2,4,6-trione (7.0g, 30 mmol) in DCM (100 mL) at 0° C. The mixture was stirred at 0° C.for 2 h, and filtered through Celite®. The filtrate was dried overNa₂SO₄ and concentrated to afford(2S,5R)-6-(benzyloxy)-7-oxo-1,6-diazabicyclo[3.2.1]octane-2-carbaldehyde(7.0 g, 90%) as a yellow oil. ESI-MS (EI⁺, m/z): 261.1. ¹H-NMR (500M,CDCl₃): 9.74 (s, 1H), 7.45-7.36 (m, 5H), 5.07 (d, J=11.5 Hz, 1H), 4.92(d, J=11.5 Hz, 1H), 3.89 (d, J=8.0 Hz, 1H), 3.27 (m, 1H), 3.21-3.05 (m,1H), 2.56 (d, J=12.0 Hz, 1H), 2.20-2.15 (m, 1H), 2.05-2.01 (m, 1H),1.95-1.93 (m, 1H), 1.49-1.46 (m, 1H).

Example 4 Synthesis of(E)-6-(benzyloxy)-7-oxo-1,6-diazabicyclo[3.2.1]octane-2-carbaldehydeoxime (intermediate compound 2c)

A solution of(2S,5R)-6-(benzyloxy)-7-oxo-1,6-diazabicyclo[3.2.1]octane-2-carbaldehyde(510 mg, 1.96 mmol), hydroxylamine hydrochloride (158 mg, 2.27 mmol) andpyridine (621 mg, 7.85 mmol) in EtOH (15 mL) was stirred at rt for 2hrs. Then, the reaction mixture was concentrated and the residue wasdiluted with DCM (25 mL), washed with water (3×), and saturated sodiumchloride, dried over Na₂SO₄ and concentrated. The residue was purifiedby silica gel column chromatography (3:1 to 3:2 petroleum ether/EtOAc)to afford(E)-6-(benzyloxy)-7-oxo-1,6-diazabicyclo[3.2.1]octane-2-carbaldehydeoxime (228 mg, 42%) as a white solid. ESI-MS (EI⁺, m/z): 276 [M+H]⁺.

Example 5 Synthesis of(2S,5R)-2-(1,2,4-oxadiazol-3-yl)-7-oxo-1,6-diazabicyclo[3.2.1]octan-6-ylhydrogen sulfate (Compound 804)

Step 1:

A mixture of (2S,5R)-1-tert-butyl 2-ethyl5-(N-(benzyloxy)-2-nitrophenylsulfonamido) piperidine-1,2-dicarboxylate(5 g, 8.9 mmol), and LiOH.H₂O (1.5 g, 35.5 mmol) in THF (30 mL) and H₂O(100 mL) was stirred at rt for 24 hrs. 1M HCl was then added to adjustthe pH to 5˜6, following by the addition of EtOAc (300 mL). The mixturewas washed with saturated sodium chloride (5×), dried over Na₂SO₄, andconcentrated. The residue was washed with petroleum ether/EtOAc (95:5,200 mL) to give(2S,5R)-5-(N-(benzyloxy)-2-nitrophenylsulfonamido)-1-(tert-butoxycarbonyl)piperidine-2-carboxylicacid (4.75 g, 99%) as a pale yellow solid. ESI-MS (EI⁺, m/z): 436.0[M+H−100]⁺.

Step 2:

NH₄Cl (1.39 g, 26.18 mmol), HOBt (3.53 g, 26.18 mmol), EDCI (5 g, 26.18mmol), and DIPEA (8.44 g, 65.45 mmol) were added to a solution of(2S,5R)-5-(N-(benzyloxy)-2-nitrophenylsulfonamido)-1-(tert-butoxycarbonyl)piperidine-2-carboxylicacid (10 g, 18.7 mmol) in DMF (90 mL) The mixture was stirred at rt for17 hrs, then, EtOAc (500 mL) was added. The mixture was washed withsaturated sodium chloride (6×), dried over Na₂SO₄, and concentrated. Theresidue was washed with petroleum ether/EtOAc (95:5, 200 mL) to give(2S,5R)-tert-butyl5-(N-(benzyloxy)-2-nitrophenylsulfonamido)-2-carbamoylpiperidine-1-carboxylate(9.9 g, 99%) which was used in the next step. ESI-MS (EI⁺, m/z): 535.0[M+H]⁺.

Step 3:

Pyridine (2 mL) was added to a solution of (2S,5R)-tert-butyl5-(N-(benzyloxy)-2-nitrophenylsulfonamido)-2-carbamoylpiperidine-1-carboxylate(1.0 g, 1.87 mmol) in dry THF (40 mL). Then, Tf₂O (1.0 mL) was slowlyadded over 5 minutes. The mixture was stirred at 0° C. for 1 h and thenEtOAc (30 mL) was added. The mixture was washed with saturated sodiumchloride (4×), dried over Na₂SO₄, and concentrated. The residue waspurified by silica gel column chromatography (gradient elution 0-40%petroleum ether/EtOAc) to give (2S,5R)-tert-butyl5-(N-(benzyloxy)-2-nitrophenylsulfonamido)-2-cyanopiperidine-1-carboxylate(0.76 g, 79%) as a yellow solid ESI-MS (EI⁺, m/z): 539.0 [M+Na]⁺.

Step 4:

A solution of (2S,5R)-tert-butyl5-(N-(benzyloxy)-2-nitrophenylsulfonamido)-2-cyanopiperidine-1-carboxylate(3.1 g, 6.008 mmol), NH₂OH.HCl (400 mg, 12 mmol), and TEA (12.136 g,120.160 mmol) in MeOH (30 mL) and EtOH (30 mL) was stirred at 70° C. for17 hrs. EtOAc (300 mL) was then added and the mixture was washed withsaturated sodium chloride (3×), dried over Na₂SO₄, and concentrated togive (2S,5R)-tert-butyl5-(N-(benzyloxy)-2-nitrophenylsulfonamido)-2-(N-hydroxycarbamimidoyl)piperidine-1-carboxylate(3.4 g, 99%) as a pale yellow solid, which was used directly in the nextstep. ESI-MS (EI⁺, m/z): 550.2 [M+H]⁺.

Step 5:

A mixture of (2S,5R)-tert-butyl5-(N-(benzyloxy)-2-nitrophenylsulfonamido)-2-(N-hydroxycarbamimidoyl)piperidine-1-carboxylate(3.0 g, 5.46 mmol), trimethoxymethane (60 mL), and PPTS (0.08 g) wasstirred at 70° C. for 4 hrs. The solvent was then removed under vacuum.The residue was purified by silica gel column chromatography (gradientelution 0-35% petroleum ether/EtOAc) to give (2S,5R)-tert-butyl5-(N-(benzyloxy)-2-nitrophenylsulfonamido)-2-(1,2,4-oxadiazol-3-yl)piperidine-1-carboxylate(2.1 g, 69%) as a yellow solid. ESI-MS (EI⁺, m/z): 582 [M+Na]⁺.

Step 6:

A mixture of(2S,5R)-tert-butyl5-(N-(benzyloxy)-2-nitrophenylsulfonamido)-2-(1,2,4-oxadiazol-3-yl)piperidine-1-carboxylate(1.5 g, 2.683 mmol), HSCH₂COOH (1.48 g, 16.1 mmol), LiOH.H₂O (1.13 g,26.83 mmol) in DMF (50 mL) was stirred at 30° C. for 17 hrs. EtOAc (150mL) was then added and the mixture was washed with water (2×), andsaturated sodium chloride (2×), dried over Na₂SO₄, and concentrated. Theresidue was purified by silica gel column chromatography (gradientelution 0˜50% petroleum ether/EtOAc) to give (2S,5R)-tert-butyl5-(benzyloxyamino)-2-(1,2,4-oxadiazol-3-yl)piperidine-1-carboxylate (700mg, 63%) as a pale yellow solid. ESI-MS (EI⁺, m/z): 375.0 [M+H]⁺.

Step 7:

TEA (405 mg, 4.0 mmol) and diphosgene (514 mg, 2.6 mmol) were added to asolution of (2S,5R)-tert-butyl5-(benzyloxyamino)-2-(1,2,4-oxadiazol-3-yl)piperidine-1-carboxylate (750mg, 2.0 mmol) in DCM (70 mL). The mixture was stirred at 0° C. for 3hrs. Then, the reaction mixture was washed with saturated sodiumchloride (2×), dried over Na₂SO₄, and concentrated to give(2S,5R)-tert-butyl5-(benzyloxy(chlorocarbonyl)amino)-2-(1,2,4-oxadiazol-3-yl)piperidine-1-carboxylate(1.6 g), which was used directly in the next step. ESI-MS (EI⁺, m/z):437[M+H]⁺.

Step 8:

A mixture of (2S,5R)-tert-butyl5-(benzyloxy(chlorocarbonyl)amino)-2-(1,2,4-oxadiazol-3-yl)piperidine-1-carboxylate(1.6 g), and 4 N HCl in dioxane (18 mL), was stirred at rt for 2 hrs.The solvent was then removed under vacuum to give(3R,6S)-6-(1,2,4-oxadiazol-3-yl)piperidin-3-yl(benzyloxy)carbamicchloride (1.4 g) as a white solid, which was used directly in the nextstep. ESI-MS (EI⁺, m/z): 301.0.

Step 9:

To a solution of(3R,6S)-6-(1,2,4-oxadiazol-3-yl)piperidin-3-yl(benzyloxy)carbamicchloride (1.4 g) in DCM (40 mL) was added TEA until the pH was adjustedtopH to 8˜9. The mixture was stirred at rt for 2 hrs then, the solventwas removed and the residue was purified by silica gel columnchromatography (gradient elution 0˜4% petroleum ether/EtOAc) to give thedesired product(2S,5R)-6-(benzyloxy)-2-(1,2,4-oxadiazol-3-yl)-1,6-diaza-bicyclo[3.2.1]octan-7-one(400 mg, 67% for 3 steps) as a white solid. ESI-MS (EI⁻, m/z): 301.2[M+H]⁺.

Step 10:

BCl₃ (1M, 3.34 mL, 3.33 mmol) was added to a solution of(2S,5R)-6-(benzyloxy)-2-(1,2,4-oxadiazol-3-yl)-1,6-diaza-bicyclo[3.2.1]octan-7-one(200 mg, 0.67 mmol) in dry DCM (45 mL) at −78° C. The mixture wasstirred at 0° C. for 2 hrs., then it was cooled to −78° C. and quenchedwith MeOH (8 mL). The solvent was removed by vacuum to give(2S,5R)-6-hydroxy-2-(1,2,4-oxadiazol-3-yl)-1,6-diaza-bicyclo[3.2.1]octan-7-one(180 mg) as a white solid, which was used directly in the next step.ESI-MS (EI⁺, m/z): 209 [M−H]⁺.

Step 11:

To a solution of(2S,5R)-6-hydroxy-2-(1,2,4-oxadiazol-3-yl)-1,6-diaza-bicyclo[3.2.1]octan-7-one(180 mg crude from above) in dry pyridine (4 mL) was added SO₃.Py (608mg). The mixture was stirred at rt for 3 hrs and then concentrated undervacuum. The residue was re-dissolved in aqueous NaH₂PO₄ (1.5 M, 50 mL)and then tetrabutylammonium hydrogensulphate (970 mg) was added. Themixture was stirred at rt for 30 minutes and then extracted with EtOAc(3×). The combined organic layer was dried and concentrated and theresidue was purified by silica gel column chromatography (gradientelution 0 to 25% EtOAc:Acetone) to afford tetrabutylammonium(2S,5R)-2-(1,2,4-oxadiazol-3-yl)-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-6-ylsulfate (280 mg, 45% for 2 steps) as a white solid. ESI-MS (EI⁻, m/z):289.0 [M−H]⁻.

Step 12, Resin Exchange:

Tetrabutylammonium(2S,5R)-2-(1,2,4-oxadiazol-3-yl)-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-6-ylsulfate (280 mg) was dissolved in a minimum amount of HPLC grade water(˜3 mL) and passed through a column of 8 g of DOWEX 50WX 8 Na⁺ resin(the resin was pre-washed with >200 mL of HPLC grade water) and elutedwith HPLC grade water to provide sodium(2S,5R)-2-(1,2,4-oxadiazol-3-yl)-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-6-ylsulfate (180 mg, 90%) as a white solid after lyophilization. ESI-MS(EI⁺, m/z): 289.1 ¹H-NMR (500 MHz, D₂O): δ 9.23 (s, 1H), 4.75 (d, J=7.5Hz, 1H), 4.20 (br s, 1H), 3.18 (m, 1H), 2.99 (d, J=12 Hz, 1H), 2.32-2.27(m, 1H), 2.21-2.14 (m, 2H), 1.97-1.92 (m, 1H).

Example 6 Synthesis of(2S,5R)-2-(5-amino-1,2,4-oxadiazol-3-yl)-7-oxo-1,6-diazabicyclo[3.2.1]octan-6-ylhydrogen sulfate (Compound 805)

Step 1:

a) NCS (0.76 g, 5.72 mmol) was added to a solution of(E)-6-(benzyloxy)-7-oxo-1,6-diaza-bicyclo[3.2.1]octane-2-carbaldehydeoxime (1.5 g, 5.45 mmol) in DCM (10 mL) then one drop of pyridine wasadded. The mixture was stirred at rt for 18 hrs, then the mixture wasconcentrated under reduced pressure and dried under high vacuum. Thecrude product was dissolved in absolute EtOH (10 mL).b) In a separate flask, guanidine hydrochloride (1.04 g, 10.9 mmol) wasmixed with EtONa (16% in EtOH, 4.63 g, 10.9 mmol) at rt, and the solidwas filtered off.

The solution of a) was added to the filtrate of b) at rt. The mixturewas stirred at rt overnight, then, the reaction mixture wasconcentrated, diluted with water (20 mL), and extracted with EtOAc (3×).The combined organic layer was dried over Na₂SO₄ and concentrated. Theresidue was purified by prep-HPLC using ammonium formate buffer toafford(2S,5R)-2-(5-amino-1,2,4-oxadiazol-3-yl)-6-(benzyloxy)-1,6-diaza-bicyclo[3.2.1]octan-7-one(120 mg, 7%) as a white solid. ESI-MS (EI⁺, m/z): 316 [M+H]⁺.

Step 2.

BCl₃ (1M, 5.08 ml, 5.08 mmol) was added to a solution of(2S,5R)-2-(5-amino-1,2,4-oxadiazol-3-yl)-6-(benzyloxy)-1,6-diaza-bicyclo[3.2.1]octan-7-one(160 mg, 0.508 mmol) in dry DCM (8 mL) at −78° C. The mixture wasstirred under N₂ atmosphere at 0° C. for 2 hrs then, it was cooled to−78° C. and quenched with MeOH (1.0 mL). The solvent was removed byvacuum to afford(2S,5R)-2-(5-amino-1,2,4-oxadiazol-3-yl)-6-hydroxy-1,6-diaza-bicyclo[3.2.1]octan-7-one(110 mg) as a white solid, which was used directly in the next step.ESI-MS (EI⁺, m/z): 226 [M+H]⁺.

Step 3:

To a mixture of(2S,5R)-2-(5-amino-1,2,4-oxadiazol-3-yl)-6-hydroxy-1,6-diaza-bicyclo[3.2.1]octan-7-one(110 mg, 0.49 mmol) and SO₃—Py (389 mg, 2.44 mmol) was added drypyridine (2 mL) under N₂. The mixture was stirred at rt for 2.5 hrs andthen concentrated under vacuum to afford(2S,5R)-2-(5-amino-1,2,4-oxadiazol-3-yl)-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-6-ylhydrogen sulfate, which was used for next step directly. ESI-MS (EI⁻,304, m/z): [M−H].

Step 4:

Crude(2S,5R)-2-(5-amino-1,2,4-oxadiazol-3-yl)-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-6-ylhydrogen sulfate was purified by Prep-HPLC using ammonium formate bufferto afford(2S,5R)-2-(5-amino-1,2,4-oxadiazol-3-yl)-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-6-ylaminooxy sulfonate (25 mg, 20% of two steps). ESI-MS (EI⁻, m/z): 304[M−H]⁻. ¹H-NMR (500 MHz, D₂O): δ 4.42 (d, J=8.0 Hz, 1H), 4.12 (s, 1H),3.12-3.09 (m, 1H), 3.00 (d, J=15 Hz, 1H), 2.11-1.96 (m, 3H), 1.86-1.79(m, 1H).

Example 7 Synthesis of(2S,5R)-7-oxo-2-(5-(piperidin-4-yl)-1,2,4-oxadiazol-3-yl)-1,6-diazabicyclo[3.2.1]octan-6-ylhydrogen sulfate (Compound 806)

Step 1:

A solution of (2S,5R)-tert-butyl5-(N-(benzyloxy)-2-nitrophenylsulfonamido)-2-(N-hydroxycarbamimidoyl)piperidine-1-carboxylate (3.12 g, 5.7 mmol),1-(((9H-fluoren-9-yl)methoxy)carbonyl)piperidine-4-carboxylic acid (2 g,5.7 mmol), HATU (3.23 g, 8.55 mmol) and DIPEA (1.50 g, 11.44 mmol) inDMF (50 mL) was stirred at rt for 1 h. EtOAc (150 mL) was then added andthe mixture was washed with saturated sodium chloride (3×), dried overNa₂SO₄, and concentrated. The residue was dissolved in dioxane (50 mL)and heated at 90° C. for 17 hrs. The mixture was then concentrated undervacuum and the residue was purified by silica gel column chromatography(gradient elution 0˜45% petroleum ether/EtOAc) to give(2S,5R)-tert-butyl2-(5-(1-(((9H-fluoren-9-yl)methoxy)carbonyl)piperidin-4-yl)-1,2,4-oxadiazol-3-yl)-5-(N-(benzyloxy)-2-nitrophenylsulfonamido)piperidine-1-carboxylate(1.2 g, 24%) as a yellow solid. ESI-MS (EI⁺, m/z): 765 [M+H−100]⁺.

Step 2:

A mixture of (2S,5R)-tert-butyl2-(5-(1-(((9H-fluoren-9-yl)methoxy)carbonyl)piperidin-4-yl)-1,2,4-oxadiazol-3-yl)-5-(N-(benzyloxy)-2-nitrophenylsulfonamido)piperidine-1-carboxylate(200 mg, 0.231 mmol), HSCH₂COOH (128 mg, 1.386 mmol) and LiOH.H₂O (97 g,2.310 mmol) in DMF (5.0 mL) was stirred at 30° C. for 17 hrs. EtOAc (50mL) was then added and the organic layer was washed with water (2×), andsaturated sodium chloride (2×), dried over Na₂SO₄, and concentrated. Theresidue was purified by silica gel column chromatography (gradientelution 0˜50% petroleum ether/EtOAc) to give (2S,5R)-tert-butyl2-(5-(1-(((9H-fluoren-9-yl)methoxy)carbonyl)piperidin-4-yl)-1,2,4-oxadiazol-3-yl)-5-(benzyloxyamino)piperidine-1-carboxylate (40 mg, 25%) as a yellow oil. ESI-MS (EI⁺,m/z): 680 [M+H]⁺

Step 3:

Diphosgene (144 mg, 0.727 mmol) was added to a solution of(2S,5R)-tert-butyl 2-(5-(1-(((9H-fluoren-9-yl)methoxy)carbonyl)piperidin-4-yl)-1,2,4-oxadiazol-3-yl)-5-(benzyloxyamino)piperidine-1-carboxylate(380 mg, 0.559 mmol) and TEA (113 mg, 1.118 mmol) in DCM (5.0 mL). Themixture was stirred at 0° C. for 1 h, then, DCM (20 mL) was added andthe mixture was washed with saturated sodium chloride (2×), dried overNa₂SO₄, and concentrated to give (2S,5R)-tert-butyl2-(5-(1-(((9H-fluoren-9-yl)methoxy)carbonyl)piperidin-4-yl)-1,2,4-oxadiazol-3-yl)-5-(benzyloxy(chlorocarbonyl)amino)piperidine-1-carboxylate(400 mg), which was directly used in the next step. ESI-MS (EI⁺, m/z):742 [M+H]⁺.

Step 4:

A mixture of (2S,5R)-tert-butyl2-(5-(1-(((9H-fluoren-9-yl)methoxy)carbonyl)piperidin-4-yl)-1,2,4-oxadiazol-3-yl)-5-(benzyloxy(chlorocarbonyl)amino)piperidine-1-carboxylate(˜400 mg) and 4 N HCl/dioxane (5.0 mL) was stirred at rt for 2 hrs. Thesolvent was then removed under vacuum to give (9H-fluoren-9-yl)methyl4-(3-((2S,5R)-5-(benzyloxy(chlorocarbonyl)amino)piperidin-2-yl)-1,2,4-oxadiazol-5-yl)piperidine-1-carboxylate(400 mg) as a white solid. ESI-MS (EI⁺, m/z): 642 [M+H]⁺.

To a solution of crude (9H-fluoren-9-yl)methyl4-(3-((2S,5R)-5-(benzyloxy(chlorocarbonyl)amino)piperidin-2-yl)-1,2,4-oxadiazol-5-yl)piperidine-1-carboxylate(400 mg) in DCM (25 mL) was added TEA until the pH was adjusted topH8˜9. The mixture was stirred at rt for 2 hrs then, the solvent wasremoved. The residue was purified by silica gel column (gradient elution0-45% petroleum ether/EtOAc) to give (9H-fluoren-9-yl)methyl4-(3-((2S,5R)-6-(benzyloxy)-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-5-yl)piperidine-1-carboxylate(100 mg, 30% for 3 steps) as a white solid. ESI-MS (EI⁻, m/z): 606[M+H]⁺.

Step 5:

BCl₃ (850 μL, 0.85 mmol, 1 M in DCM) was added to a solution of(9H-fluoren-9-yl) methyl4-(3-((2S,5R)-6-(benzyloxy)-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-5-yl)piperidine-1-carboxylate(100 mg, 0.17 mmol) in dry DCM (10 mL) at −78° C. The mixture wasstirred under N₂ atmosphere at 0° C. for 6 hrs, cooled to −78° C., thenMeOH (1 mL) was slowly added. The solvents were evaporated under vacuumat 0° C. to give (9H-fluoren-9-yl)methyl4-(3-((2S,5R)-6-hydroxy-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-5-yl)piperidine-1-carboxylate(97 mg) as a yellow solid, which was used directly in the next step.ESI-MS (EI⁺, m/z): 516.3 [M+H]⁻.

Step 6:

To a solution of crude (9H-fluoren-9-yl)methyl4-(3-((2S,5R)-6-hydroxy-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-5-yl)piperidine-1-carboxylate(97 mg) in dry pyridine (2 mL) was added SO₃.Py (140 mg, 0.85 mmol). Themixture was stirred at rt for 6 hrs and then concentrated under vacuum.The residue was re-dissolved in aqueous NaH₂PO₄ (1.5 M, 10 mL) thentetrabutylammonium hydrogensulphate (75 mg) was added. The mixture wasstirred at rt for 20 minutes, then extracted with EtOAc (3×). Thecombined organic layer was dried and concentrated. The residue waspurified by silica gel column chromatography (gradient elution 10:1 to2:1 DCM/acetone) to give tetrabutylammonium (9H-fluoren-9-yl)methyl4-(3-((2S,5R)-7-oxo-6-(sulfooxy)-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-5-yl)piperidine-1-carboxylatesulfate as a white solid (84 mg, 61% for two steps). ESI-MS (EI⁺, m/z):594.1 [M−H]⁻.

Step 7:

Et₂NH (0.5 mL, 5.0 mmol)) was added to a solution of tetrabutylammonium(9H-fluoren-9-yl)methyl4-(3-((2S,5R)-7-oxo-6-(sulfooxy)-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-5-yl)piperidine-1-carboxylatesulfate (84 mg, 0.1 mmol) in dry DCM (10 mL. The mixture was stirred atrt for 12 hrs and the solvents were evaporated under vacuum. The residuewas purified by prep-HPLC to afford(2S,5R)-7-oxo-2-(5-(piperidin-4-yl)-1,2,4-oxadiazol-3-yl)-1,6-diaza-bicyclo[3.2.1]octan-6-ylhydrogen sulfate (9.0 mg). ESI-MS (EI⁺, m/z): 374.15 [M+H]⁺. ¹H NMR (300MHz, D₂O) δ 4.61 (d, J=6.0 Hz, 1H), 4.12 (br s, 1H), 3.50-3.33 (m, 3H),3.15-3.05 (m, 3H), 2.91 (d, J=12.2 Hz, 1H), 2.35-1.72 (m, 8H).

Example 8 Synthesis of(2S,5R)-2-(1,2,4-oxadiazol-5-yl)-7-oxo-1,6-diazabicyclo[3.2.1]octan-6-ylhydrogen sulfate (Compound 801)

Step 1:

DIPEA (5.8 mL, 36.2 mmol) was added to a solution of(2S,5R)-6-(benzyloxy)-7-oxo-1,6-diaza-bicyclo[3.2.1]octane-2-carboxylicacid (5.0 g, 18.1 mmol), EDCI (5.2 g, 27.2 mmol), HOBT (3.7 g, 27.2mmol) and NH₄Cl (1.94 g, 36.2 mmol) in DMF (60 mL) at rt. The reactionmixture was stirred for 17 hrs, then diluted with ice water (100 mL) andextracted with EtOAc (3×). The combined organic layer was dried overNa₂SO₄, and concentrated. The residue was purified by silica gel columnchromatography (2:1 EtOAc/petroleum ether) to afford(2S,5R)-6-(benzyloxy)-7-oxo-1,6-diaza-bicyclo[3.2.1]octane-2-carboxamide(4.0 g, 80%) as a white solid. ESI-MS (EI⁺, m/z): 276 [M+H]⁺.

Step 2.

Dimethoxy-N,N-dimethylmethanamine (0.97 mL, 7 mmol) was added to asolution of(2S,5R)-6-(benzyloxy)-7-oxo-1,6-diaza-bicyclo[3.2.1]octane-2-carboxamide(1.38 g, 5 mmol) in 1,4-dioxane (20 mL) at rt. The mixture was stirredat 45-50° C. for 2 hrs under vacuum to remove the methanol formed duringthe reaction. Then, the reaction mixture was concentrated under vacuum,and the residue was washed with Et₂O (2×) and dried to give(2S,5R,Z)-6-(benzyloxy)-N-((dimethylamino)methylene)-7-oxo-1,6-diaza-bicyclo[3.2.1]octane-2-carboxamide(1.33 g, 80%) as a white solid. (ESI-MS (EI⁻, 331, m/z): [M+H]⁺.

Step 3:

(2S,5R,Z)-6-(benzyloxy)-N-((dimethylamino)methylene)-7-oxo-1,6-diaza-bicyclo[3.2.1]octane-2-carboxamide(1.33 g, 4.03 mmol) in EtOH (22 mL) was treated with pyridine (0.64 ml,8.06 mmol), followed by the addition of a solution of HOSA (547 mg, 4.84mmol) in MeOH (4.5 mL). The resulting mixture was stirred at rt for 30minutes and then concentrated under vacuum. The residue was dissolved inDCM/THF (1:2, 30 mL) and washed with water (10 mL). The organic layerwas dried over Na₂SO₄, and concentrated. The residue was re-dissolved inEtOH (22 mL) and 2N HCl (8.0 mL). The mixture was heated at reflux for20 minutes, concentrated and extracted with DCM (2×). The crude materialwas purified by prep-HPLC to give(2S,5R)-6-(benzyloxy)-2-(1,2,4-oxadiazol-5-yl)-1,6-diaza-bicyclo[3.2.1]octan-7-one(50 mg, 4.1%) as a light yellow oil. ESI-MS (EI⁻, 301, m/z): [M+H]⁺.¹H-NMR (500 MHz, CDCl₃): δ 8.44 (s, 1H), 7.45-7.35 (m, 5H), 5.09 (d,J=11.5 Hz, 1H), 4.94 (d, J=11.5 Hz, 1H), 4.85 (d, J=8.0 Hz, 1H), 3.36(m, 1H), 3.01 (d, J=12.0 Hz, 1H), 2.81 (d, J=12.0 Hz, 1H), 2.37-2.35 (m,1H), 2.25-2.21 (m, 1H), 2.01-2.00 (m, 1H), 1.85-1.84 (m, 1H).

Step 4:

BCl₃ (1M in DCM, 1.2 mL, 1.2 mmol) was added to(2S,5R)-6-(benzyloxy)-2-(1,2,4-oxadiazol-5-yl)-1,6-diaza-bicyclo[3.2.1]octan-7-one(50 mg, 0.167 mmol) in DCM (10 mL) at −78° C. The mixture was warmed to0° C. and stirred for 2 hrs. The reaction was then quenched by theaddition of MeOH (1 mL) and the resulting solution was concentratedunder vacuum to give(2S,5R)-6-hydroxy-2-(1,2,4-oxadiazol-5-yl)-1,6-diaza-bicyclo[3.2.1]octan-7-one(34 mg, 98%) as a white solid, which was used directly in the next step.ESI-MS (EI⁻, 211, m/z): [M+H]⁺.

Step 5:

A mixture of(2S,5R)-6-hydroxy-2-(1,2,4-oxadiazol-5-yl)-1,6-diaza-bicyclo[3.2.1]octan-7-one(48 mg, 0.228 mmol) and SO₃—Py (182 mg, 1.14 mmol) in dry pyridine (2mL) was stirred at rt for 2.5 hrs. The reaction mixture was thenconcentrated in vacuum and the residue was re-dissolved in aqueousNaH₂PO₄ (1.5 M, 10 mL). Tetrabutylammonium hydrogensulphate (105 mg) wasadded, the mixture was stirred at rt for 15 minutes, and then extractedwith EtOAc (4×). The combined organic layer was dried and concentrated.The residue was purified by silica gel column chromatography (gradientelution 10:1 to 1:1 DCM/acetone) to give tetrabutylammonium(2S,5R)-2-(1,2,4-oxadiazol-5-yl)-7-oxo-1,6-diazabicyclo[3.2.1]octan-6-ylsulfate (50 mg, 41%) as a white solid. ESI-MS (EI⁻, 289, m/z): [M−H]⁻.

Step 6:

Tetrabutylammonium(2S,5R)-2-(1,2,4-oxadiazol-5-yl)-7-oxo-1,6-diazabicyclo[3.2.1]octan-6-ylsulfate (50 mg) was dissolved in a minimum amount of HPLC grade water(˜1 mL) and passed through a column of 2 g of DOWEX 50WX 8 Na⁺ resin(the resin was pre-washed with >0.5 L of HPLC grade water) and elutedwith HPLC grade water to afford sodium(2S,5R)-2-(1,2,4-oxadiazol-5-yl)-7-oxo-1,6-diazabicyclo[3.2.1]octan-6-ylsulfate (21 mg, 72%) as a white solid after lyophilization. ESI-MS (EI⁻,m/z): 289 [M−H]⁻. ¹H-NMR (500 MHz, CDCl₃): δ 8.76 (s, 1H), 4.92 (d,J=7.5 Hz, 1H), 4.24 (s, 1H), 3.29 (d, J=12.5 Hz, 1H), 2.98 (d, J=12.5Hz, 1H), 2.42-2.38 (m, 1H), 2.29-2.20 (m, 2H), 2.0-1.97 (m, 1H).

Example 9 Synthesis of(2S,5R)-2-(3-amino-1,2,4-oxadiazol-5-yl)-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-6-yltetrabutylaminooxy sulfonate (Compound 802)

Step 1:

Hydroxylamine (50% in water, 3.6 mL, 0.059 mol) was added to cyanamide(50% in water, 3.24 g, 0.077 mol) in methanol (100 mL). The mixture washeated to reflux for 4.5 hrs and concentrated to remove methanol/water,followed by co-evaporation with methanol (2×) to remove residual waterto obtain 1-hydroxyguanidine (3.0 g, 68%) as a light yellow solid.

Step 2:

A solution of(2S,5R)-6-(benzyloxy)-2-(5-(piperidin-4-yl)-1,3,4-oxadiazol-2-yl)-1,6-diazabicyclo[3.2.1]octan-7-one(2.0 g, 7.25 mmol), EDCI (1.53 g, 7.98 mmol) and HOBT (1.08 g, 7.98mmol) in DMF (15 mL) was stirred at rt for 0.5 h. 1-Hydroxyguanidine(0.653 g, 7.98 mmol) was then added and the reaction mixture was stirredfor an additional 0.5 h. The resulting solution was treated undermicrowave at 100° C. for 1.5 hrs. The mixture was poured into water andextracted with EtOAc (2×). The combined organic layers were then washedwith water (20 mL), and saturated sodium chloride (20 mL), dried overNa₂SO₄, and concentrated. The residue was purified by silica gel columnchromatography (2:1 EtOAc/petroleum ether) to give(2S,5R)-2-(3-amino-1,2,4-oxadiazol-5-yl)-6-(benzyloxy)-1,6-diaza-bicyclo[3.2.1]octan-7-one(1.0 g, 44%). (ESI-MS (EI⁺, m/z): 316 [M+H]⁺.

Step 3:

BCl₃ (1M, 15.87 mL, 15.87 mmol) was added to a solution of(2S,5R)-2-(3-amino-1,2,4-oxadiazol-5-yl)-6-(benzyloxy)-1,6-diaza-bicyclo[3.2.1]octan-7-one(1.0 g, 3.17 mmol) in dried DCM (20 mL) at −78° C. The mixture wasstirred under N₂ atmosphere at 0° C. for 2 hrs, cooled to −78° C. andquenched with MeOH (2 mL). The solvent was removed under vacuum to give((2S,5R)-2-(3-amino-1,2,4-oxadiazol-5-yl)-6-hydroxy-1,6-diaza-bicyclo[3.2.1]octan-7-one(700 mg), which was used in the next step directly. ESI-MS (EI⁺, m/z):226 [M+H]⁺.

Step 4:

A mixture of((2S,5R)-2-(3-amino-1,2,4-oxadiazol-5-yl)-6-hydroxy-1,6-diaza-bicyclo[3.2.1]octan-7-one(700 mg, 3.11 mmol) and SO₃.Py (1.48 g, 9.33 mmol) in dry pyridine (5mL) was stirred at rt for 2.5 hrs. The reaction mixture was thenconcentrated under vacuum. then re-dissolved in aqueous NaH₂PO₄ (1.5 M,30 mL). Tetrabutylammonium hydrogensulphate (1.16 g) was added, themixture stirred at rt for 15 minutes, and then extracted with EtOAc(4×). The combined organic layer was dried and concentrated and theresidue was purified by silica gel column chromatography (gradientelution 10:1 to 5:1 DCM/acetone) to afford tetrabutylammonium(2S,5R)-2-(3-amino-1,2,4-oxadiazol-5-yl)-7-oxo-1,6-diazabicyclo[3.2.1]octan-6-ylsulfate (1.7 g) as a white solid. (ESI-MS (EI⁻, 304, m/z): [M−H]⁻.¹H-NMR (500 MHz, DMSO-d₆): δ 6.4 (s, 2H), 4.48 (d, J=8.0 Hz, 1H), 3.67(s, 1H), 3.24-3.14 (m, 8H), 3.00 (d, J=12 Hz, 1H), 2.24 (d, J=11.5 Hz,1H), 2.2-2.06 (m, 3H), 1.87-1.82 (m, 1H), 1.59-1.53 (m, 8H), 1.35-1.27(m, 8H), 0.93-0.82 (m, 12H).

Step 5:

Tetrabutylammonium(2S,5R)-2-(3-amino-1,2,4-oxadiazol-5-yl)-7-oxo-1,6-diazabicyclo[3.2.1]octan-6-ylsulfate was further purified by prep-HPLC using ammonium formate bufferto afford(2S,5R)-2-(3-amino-1,2,4-oxadiazol-5-yl)-7-oxo-1,6-diazabicyclo[3.2.1]octan-6-ylhydrogen sulfate. ESI-MS (EI⁺, m/z): 306.1. ¹H NMR (300 MHz, D₂O) δ 4.19(br s, 1H), 3.27-3.23 (m, 1H), 3.04-2.97 (m, 1H), 2.39-1.66 (m, 4H).

Example 10 Synthesis of(2S,5R)-7-oxo-2-(3-(piperidin-4-yl)-1,2,4-oxadiazol-5-yl)-1,6-diazabicyclo[3.2.1]octan-6-ylhydrogen sulfate (Compound 803)

Step 1:

CDI (511.3 mg, 3.1 mmol) was added to a solution of crude(2S,5R)-6-(benzyloxy)-2-(5-(piperidin-4-yl)-1,3,4-oxadiazol-2-yl)-1,6-diazabicyclo[3.2.1]octan-7-one(726 mg, 2.6 mmol) in DMF (15 mL). The mixture was stirred at rt for 1h, then, (E)-tert-butyl4-(N′-hydroxycarbamimidoyl)piperidine-1-carboxylate (631.8 mg, 2.6 mmol)was added at rt. The mixture was stirred at rt for 2 hrs, and thenstirred at 50° C. for another 6 hrs. The mixture was diluted with EtOAc(150 mL) and washed with 1 M HCl (2×), water (2×), and saturated sodiumchloride (2×), dried over Na₂SO₄, and concentrated. The residue waspurified by silica gel column chromatography (1:5 to 1:1 EtOAc/hexanes)to give tert-butyl4-(5-((2S,5R)-6-(benzyloxy)-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-3-yl)piperidine-1-carboxylate(968 mg, 76%) as a white solid. ESI-MS (EI⁺, m/z): 506.2 [M+Na]⁺. ¹H-NMR(400 MHz, CDCl₃): δ 7.47-7.36 (m, 5H), 4.99-4.94 (m, 2H), 4.73 (d, J=6.0Hz, 1H), 3.93 (d, J=9.6 Hz, 1H), 3.72 (s, 1H), 3.08-2.90 (m, 4H), 2.72(d, J=9.6 Hz, 1H), 2.15 (dd, J=12.0, 5.2 Hz, 1H), 2.09-1.93 (m, 5H),1.85-1.79 (m, 1H), 1.59-1.50 (m, 2H), 1.40 (s, 9H).

Step 2:

CF₃COOH (4 mL) was added to the solution of tert-butyl4-(5-((2S,5R)-6-(benzyloxy)-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-3-yl)piperidine-1-carboxylate(960 mg, 2.0 mmol) in 16 mL of CH₂Cl₂ at 0° C. The mixture was stirredat 0° C. for 2 hrs, then concentrated to give(2S,5R)-6-(benzyloxy)-2-(3-(piperidin-4-yl)-1,2,4-oxadiazol-5-yl)-1,6-diaza-bicyclo[3.2.1]octan-7-one(1.1 g) as a brown oil, which was used directly in the next step. ESI-MS(EI⁺, m/z): 384.2 [M+H]⁺.

Step 3:

DIPEA (1.6 mL, 10.0 mmol) was slowly added dropwise to a solution of(2S,5R)-6-(benzyloxy)-2-(3-(piperidin-4-yl)-1,2,4-oxadiazol-5-yl)-1,6-diaza-bicyclo[3.2.1]octan-7-one(1.1 g, 2.0 mmol) in THF (50 mL) at 0° C. The mixture was stirred underN₂ atmosphere at 0° C. for 15 minutes, then, Fmoc-OSu (2.4 g, 7.2 mmol)was added and the mixture was stirred at rt. for 8 hrs. The mixture wasconcentrated and the residue was purified by silica gel columnchromatography (gradient elution 1:6 to 1:2 EtOAc/hexanes) to give(9H-fluoren-9-yl)methyl4-(5-((2S,5R)-6-(benzyloxy)-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-3-yl)piperidine-1-carboxylate(1.0 g, 86%) as a white solid.

Step 4:

BCl₃ (8.5 ml, 8.5 mmol; 1 M in CH₂Cl₂) was added dropwise to a solutionof (9H-fluoren-9-yl)methyl4-(5-((2S,5R)-6-(benzyloxy)-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-3-yl)piperidine-1-carboxylate(1.0 g, 1.7 mmol, 1.0 eq.) in dried CH₂Cl₂ (20 mL) at −78° C. Themixture was stirred under N₂ atmosphere at 0° C. for 6 hrs. Then, thereaction mixture was cooled to −78° C. and MeOH (2 mL) was addeddropwise. The solvents were evaporated under vacuum at 0° C. to give((9H-fluoren-9-yl)methyl4-(5-((2S,5R)-6-hydroxy-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-3-yl)piperidine-1-carboxylate(970 mg) as a yellow solid, which was used directly in the next step.ESI-MS (EI⁻, m/z): 516.3 [M+H]⁻.

Step 5:

To a solution of ((9H-fluoren-9-yl)methyl4-(5-((2S,5R)-6-hydroxy-7-oxo-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-3-yl)piperidine-1-carboxylate(970 mg) in dry pyridine (15 mL) was added SO₃.Py (1.4 g, 8.5 mmol). Themixture was stirred at rt for 6 h and then concentrated under vacuum.The resulting residue was then re-dissolved in aqueous NaH₂PO₄ (1.5 M,100 mL) and Tetrabutylammonium hydrogensulphate (746 mg) was added. Themixture was stirred at rt for 30 minutes, then extracted with EtOAc(4×). The combined organic layer was dried and concentrated and theresidue was purified by silica gel column chromatography (gradientelution 10:1 to 2:1 CH₂Cl₂/acetone) to afford tetrabutylammonium(9H-fluoren-9-yl)methyl4-(5-((2S,5R)-7-oxo-6-(sulfooxy)-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-3-yl)piperidine-1-carboxylatesulfate as a white solid (1.0 g, 71% for two steps). ESI-MS (EI⁻, m/z):594.1 [M−H]⁻.

Step 6:

Et₂NH (6.1 mL, 60.0 mmol) was added to a solution of tetrabutylammonium(9H-fluoren-9-yl)methyl4-(5-((2S,5R)-7-oxo-6-(sulfoxy)-1,6-diaza-bicyclo[3.2.1]octan-2-yl)-1,2,4-oxadiazol-3-yl)piperidine-1-carboxylatesulfate (1.0 g, 1.2 mmol) in dried CH₂Cl₂ (30 mL). The mixture wasstirred under N₂ atmosphere at rt. for 12 hrs, then evaporated undervacuum. The residue was purified by prep-HPLC using the ammonium formateconditions. E SI-MS (EI⁺, m/z): 314.2. ¹H NMR (300 MHz, D₂O) δ 4.82 (d,J=8.0 Hz, 1H), 4.17 (br s, 1H), 3.47-3.45 (m, 2H), 3.25-3.12 (m, 3H),2.96-2.92 (m, 1H), 2.39-1.94 (m, 8H).

Example 11 Construction of Isogenic β-Lactamase Strains

A set of β-lactamase expressing isogenic E. coli strains was constructedby cloning a β-lactamase gene into a customized derivative of pBR322(GenBank Accession Number J01749) and transforming the engineeredplasmids into E. coli. The NdeI restriction site within the plasmidbackbone of pBR322 was removed to generate pBR322 ΔNdeI. The pBR322ΔNdeI vector itself, minus the blaTEM-1 gene, was amplified using twoprimers: (1) pBR-Pbla 5′-cgcatatgactcttcctttttcaatattattg-3, SEQ ID 1, aprimer with an engineered NdeI restriction site at the 3′ end of theblaTEM-1 promoter and (2) pBR-vec-1 5′-gcggatccctgtcagaccaagtttactc-3′,SEQ ID 2, a primer with an engineered BamHI restriction site at the 3′end of the blaTEM-1 open reading frame. The chloramphenicol resistancegene, cat, was generated by PCR amplification from pKD3 (GenBankAccession Number AY048742) using primers with an engineered NdeIrestriction site at the 5′ end (Pbla-cat5′-gccatatgatggagaaaaaaatcactgg-3′, SEQ ID 3) and an engineered BamHIrestriction site at the 3′ end (Vec-1-cat5′-cgggatccctagagaataggaacttcgg-3′, SEQ ID 4) of the resistance gene.The two PCR products, pBR322 ΔNdeI and cat were ligated togethergenerating pBR-CBST (pBR322 ΔNdeI ΔTEM-1:: cat Seq. ID 5) which retainsboth the pBR322 tetracycline resistance cassette, tetA, and the plasmidorigin of replication but the blaTEM-1 gene was replaced by the catgene.

Using this engineering strategy a number of plasmids producingβ-lactamase genes from different classes (see below) were generatedusing synthetic genes with an engineered NdeI restriction site at the 5′end and BamHI restriction site at the 3′ end of each gene (GenScript).Both the synthetic β-lactamase genes and cat gene were ligated into theNdeI/BamHI sites of the pBR322 ΔNdeI PCR product and transformed intoelectrocompetent E. coli ElectroMax DH10B (Invitrogen/LifeTechnologies). E. coli DH10B harboring the recombinant plasmids wereselected on LB agar (supplemented with 25 μg/mL tetracycline) and singleisolated colonies were then inoculated into 5 mL LB media (supplementedwith 25 μg/mL tetracycline), and incubated at 37° C. with aeration (250rpm) for 18 hrs. The cultures were frozen back at −80° C. in 20%glycerol. The DNA sequence of the cloned β-lactamase genes wasconfirmed. The β-lactamase gene expression in the recombinant E. colistrains was driven by the blaTEM-1 promoter in the pBR-CBST plasmid andwas characterized by MIC profiling of the E. coli recombinant strainsagainst comparator β-lactam/BLI combinations in broth microdilutionassay.

GenBank Accession Number of β-Lactamase Name & SEQ. ID of β-Species Origin of β-Lactamase Expressing plasmids producing Lactamaseβ-Lactamase Gene Strain β-Lactamase Class Gene Sequence KPC-2pBR-CBST-KPC-2 A K. pneumoniae EU784136 SEQ ID 6 CTX-M-15pBR-CBST-CTX-M-15 A K. pneumoniae JF775516 SEQ ID 7 SHV-12pBR-CBST-SHV-12 A K. pneumoniae AY008838 SEQ ID 8 P99 AmpCpBR-CBST-P99 AMPC C E. cloacea X07274 SEQ ID 9 OXA-15 pBR-CBST-OXA-15 DP. aeruginosa PAU63835 SEQ ID 10 KPC-4 pBR-CBST-KPC-4 A K. pneumoniaeEU447304 SEQ ID 11 DHA-1 pBR-CBST-DHA-1 C K. pneumoniae AY585202SEQ ID 12 ADC-33 pBR-CBST-ADC-33 C A. baumannii EU687478 SEQ ID 13Nucleotide Sequences of pBR-CBST Plasmids (Containing β-Lactamase or catGenes) Used in the E. coli Isogenic Strains (relevant restriction sites are underlined;β-lactamase sequences in all caps, tetA sequence is in italics)pBR-CBST-cat SEQ ID 5ttcttgaagacgaaagggcctcgtgatacgcctatttttataggttaatgtcatgataataatggtttcttagacgtcaggtggcacttttcggggaaatgtgcgcggaacccctatttgtttatttttctaaatacattcaaatatgtatccgctcatgagacaataaccctgataaatgcttcaataatattgaaaaaggaagagtcatATGGAGAAAAAAATCACTGGATATACCACCGTTGATATATCCCAATGGCATCGTAAAGAACATTTTGAGGCATTTCAGTCAGTTGCTCAATGTACCTATAACCAGACCGTTCAGCTGGATATTACGGCCTTTTTAAAGACCGTAAAGAAAAATAAGCACAAGTTTTATCCGGCCTTTATTCACATTCTTGCCCGCCTGATGAATGCTCATACGGAATTTCGTATGGCAATGAAAGACGGTGAGCTGGTGATATGGGATAGTGTTCACCCTTGTTACACCGTTTTCCATGAGCAAACTGAAACGTTTTCATCGCTCTGGAGTGAATACCACGACGATTTCCGGCAGTTTCTACACATATATTCGCAAGATGTGGCGTGTTACGGTGAAAACCTGGCCTATTTCCCTAAAGGGTTTATTGAGAATATGTTTTTCGTCTCAGCCAATCCCTGGGTGAGTTTCACCAGTTTTGATTTAAACGTGGCCAATATGGACAACTTCTTCGCCCCCGTTTTCACTATGGGCAAATATTATACGCAAGGCGACAAGGTGCTGATGCCGCTGGCGATTCAGGTTCATCATGCCGTCTGTGATGGCTTCCATGTCGGCAGAATGCTTAATGAATTACAACAGTACTGCGATGAGTGGCAGGGCGGGGCGTAAGTGGCAGGGCGGGGCGTAAGGCGCGCCATTTAAATGAAGTTCCTATTCCGAAGTTCCTATTCTCTAGggatccctgtcagaccaagtttactcatatatactttagattgatttaaaacttcatttttaatttaaaaggatctaggtgaagatcctttttgataatctcatgaccaaaatcccttaacgtgagttttcgttccactgagcgtcagaccccgtagaaaagatcaaaggatcttcttgagatcctttttttctgcgcgtaatctgctgcttgcaaacaaaaaaaccaccgctaccagcggtggtttgtttgccggatcaagagctaccaactctttttccgaaggtaactggcttcagcagagcgcagataccaaatactgtccttctagtgtagccgtagttaggccaccacttcaagaactctgtagcaccgcctacatacctcgctctgctaatcctgttaccagtggctgctgccagtggcgataagtcgtgtcttaccgggttggactcaagacgatagttaccggataaggcgcagcggtcgggctgaacggggggttcgtgcacacagcccagcttggagcgaacgacctacaccgaactgagatacctacagcgtgagctatgagaaagcgccacgcttcccgaagggagaaaggcggacaggtatccggtaagcggcagggtcgguacaggagagcgcacgagggagcttccagggggaaacgcctggtatctttatagtcctgtcgggtttcgccacctctgacttgagcgtcgatttttgtgatgctcgtcaggggggcggagcctatggaaaaacgccagcaacgcggcctttttacggttcctggccttttgctggccttttgctcacatgttctttcctgcgttatcccctgattctgtggataaccgtattaccgcctttgagtgagctgataccgctcgccgcagccgaacgaccgagcgcagcgagtcagtgagcgaggaagcggaagagcgcctgatgcggtattttctccttacgcatctgtgcggtatttcacaccgcatttggtgcactctcagtacaatctgctctgatgccgcatagttaagccagtatacactccgctatcgctacgtgactgggtcatggctgcgccccgacacccgccaacacccgctgacgcgccctgacgggcttgtctgctcccggcatccgcttacagacaagctgtgaccgtctccgggagctgcatgtgtcagaggttttcaccgtcatcaccgaaacgcgcgaggcagctgcggtaaagctcatcagcgtggtcgtgaagcgattcacagatgtctgcctgttcatccgcgtccagctcgttgagtttctccagaagcgttaatgtctggcttctgataaagcgggccatgttaagggcggttttttcctgtttggtcactgatgcctccgtgtaagggggatttctgttcatgggggtaatgataccgatgaaacgagagaggatgctcacgatacgggttactgatgatgaacatgcccggttactggaacgttgtgagggtaaacaactggcggtatggatgcggcgggaccagagaaaaatcactcagggtcaatgccagcgcttcgttaatacagatgtaggtgttccacagggtagccagcagcatcctgcgatgcagatccggaacataatggtgcagggcgctgacttccgcgtttccagactttacgaaacacggaaaccgaagaccattcatgttgttgctcaggtcgcagacgtttgcagcagcagtcgcttcacgttcgctcgcgtatcggtgattcattctgctaaccagtaaggcaaccccgccagcctagccgggtcctcaacgacaggagcacgatcatgcgcacccgtggccaggacccaacgctgcccgagatgcgccgcgtgcggctgctggagatggcggacgcgatggatatgttctgccaagggttggtttgcgcattcacagttctccgcaagaattgattggctccaattcttggagtggtgaatccgttagcgaggtgccgccggcttccattcaggtcgaggtggcccggctccatgcaccgcgacgcaacgcggggaggcagacaaggtatagggcggcgcctacaatccatgccaacccgttccatgtgctcgccgaggcggcataaatcgccgtgacgatcagcggtccagtgatcgaagttaggctggtaagagccgcgagcgatccttgaagctgtccctgatggtcgtcatctacctgcctggacagcatggcctgcaacgcgggcatcccgatgccgccggaagcgagaagaatcataatggggaaggccatccagcctcgcgtcgcgaacgccagcaagacgtagcccagcgcgtcggccgccatgccggcgataatggcctgcttctcgccgaaacgtttggtggcgggaccagtgacgaaggcttgagcgagggcgtgcaagattccgaataccgcaagcgacaggccgatcatcgtcgcgctccagcgaaagcggtcctcgccgaaaatgacccagagcgctgccggcacctgtcctacgagttgcatgataaagaagacagtcataagtgcggcgacgatagtcatgcccgcgcccaccggaaggagctgactgggttgaaggctctcaagggcatcggtcgacgctctcccttatgcgactcctgcattaggaagcagcccagtagtaggttgaggccgttgagcaccgccgccgcaaggaatggtgcatgcaaggagatggcgcccaacagtccccatcggtgatgtcggcgatataggcgccagcaaccgcacctgtggcgccggtgatgccggccacgatgcgtccggcgtagaggattcacaggacgggtgtggtcgccatgatcgcgtagtcgatagtggctccaagtagcgaagcgagcaggactgggcggcggccaaagcggtcggacagtgctccgagaacgggtgcgcatagaaattgcatcaacgcatatagcgctagcagcacgccatagtgactggcgatgctgtcggaatggacgatatcccgcaagaggcccggcagtaccggcataaccaagcctatgcctacagcatccagggtgacggtgccgaggatgacgatgagcgcattgttagatttcatacacggtgcctgactgcgttagcaatttaactgtgataaactaccgcattaaagcttatcgatgataagctgtcaaacatgagaapBR-CBST-KPC-2 SEQ ID 6ttcttgaagacgaaagggcctcgtgatacgcctatttttataggttaatgtcatgataataatggtttcttagacgtcaggtggcacttttcggggaaatgtgcgcggaacccctatttgtttatttttctaaatacattcaaatatgtatccgctcatgagacaataaccctgataaatgcttcaataatattgaaaaaggaagagtcatATGTCACTGTATCGCCGTCTAGTTCTGCTGTCTTGTCTCTCATGGCCGCTGGCTGGCTTTTCTGCCACCGCGCTGACCAACCTCGTCGCGGAACCATTCGCTAAACTCGAACAGGACTTTGGCGGCTCCATCGGTGTGTACGCGATGGATACCGGCTCAGGCGCAACTGTAAGTTACCGCGCTGAGGAGCGCTTCCCACTGTGCAGCTCATTCAAGGGCTTTCTTGCTGCCGCTGTGCTGGCTCGCAGCCAGCAGCAGGCCGGCTTGCTGGACACACCCATCCGTTACGGCAAAAATGCGCTGGTTCCGTGGTCACCCATCTCGGAAAAATATCTGACAACAGGCATGACGGTGGCGGAGCTGTCCGCGGCCGCCGTGCAATACAGTGATAACGCCGCCGCCAATTTGTTGCTGAAGGAGTTGGGCGGCCCGGCCGGGCTGACGGCCTTCATGCGCTCTATCGGCGATACCACGTTCCGTCTGGACCGCTGGGAGCTGGAGCTGAACTCCGCCATCCCAGGCGATGCGCGCGATACCTCATCGCCGCGCGCCGTGACGGAAAGCTTACAAAAACTGACACTGGGCTCTGCACTGGCTGCGCCGCAGCGGCAGCAGTTTGTTGATTGGCTAAAGGGAAACACGACCGGCAACCACCGCATCCGCGCGGCGGTGCCGGCAGACTGGGCAGTCGGAGACAAAACCGGAACCTGCGGAGTGTATGGCACGGCAAATGACTATGCCGTCGTCTGGCCCACTGGGCGCGCACCTATTGTGTTGGCCGTCTACACCCGGGCGCCTAACAAGGATGACAAGCACAGCGAGGCCGTCATCGCCGCTGCGGCTAGACTCGCGCTCGAGGGATTGGGCGTCAACGGGCAGTAAggatccctgtcagaccaagtttactcatatatactttagattgatttaaaacttcatttttaatttaaaaggatctaggtgaagatcctttttgataatctcatgaccaaaatcccttaacgtgagttttcgttccactgagcgtcagaccccgtagaaaagatcaaaggatcttcttgagatcctttttttctgcgcgtaatctgctgcttgcaaacaaaaaaaccaccgctaccagcggtggtttgtttgccggatcaagagctaccaactctttttccgaaggtaactggcttcagcagagcgcagataccaaatactgtccttctagtgtagccgtagttaggccaccacttcaagaactctgtagcaccgcctacatacctcgctctgctaatcctgttaccagtggctgctgccagtggcgataagtcgtgtcttaccgggttggactcaagacgatagttaccggataaggcgcagcggtcgggctgaacggggggttcgtgcacacagcccagcttggagcgaacgacctacaccgaactgagatacctacagcgtgagctatgagaaagcgccacgcttcccgaagggagaaaggcggacaggtatccggtaagcggcagggtcggaacaggagagcgcacgagggagcttccagggggaaacgcctggtatctttatagtcctgtcgggtttcgccacctctgacttgagcgtcgatttttgtgatgctcgtcaggggggcggagcctatggaaaaacgccagcaacgcggcctttttacggttcctggccttttgctggccttttgctcacatgttctttcctgcgttatcccctgattctgtggataaccgtattaccgcctttgagtgagctgataccgctcgccgcagccgaacgaccgagcgcagcgagtcagtgagcgaggaagcggaagagcgcctgatgcggtattttctccttacgcatctgtgcggtatttcacaccgcatttggtgcactctcagtacaatctgctctgatgccgcatagttaagccagtatacactccgctatcgctacgtgactgggtcatggctgcgccccgacacccgccaacacccgctgacgcgccctgacgggcttgtctgctcccggcatccgcttacagacaagctgtgaccgtctccgggagctgcatgtgtcagaggttttcaccgtcatcaccgaaacgcgcgaggcagctgcggtaaagctcatcagcgtggtcgtgaagcgattcacagatgtctgcctgttcatccgcgtccagctcgttgagtttctccagaagcgttaatgtctggcttctgaiaaagcgggccatgttaagggcggttttttcctgtttggtcactgatgcctccgtgtaagggggatttctgttcatgggggtaatgataccgatgaaacgagagaggatgctcacgatacgggttactgatgatgaacatgcccggttactggaacgttgtgagggtaaacaactggcggtatggatgcggcgggaccagagaaaaatcactcagggtcaatgccagcgcttcgttaatacagatgtaggtgttccacagggtagccagcagcatcctgcgatgcagatccggaacataatggtgcagggcgctgacttccgcgtttccagactttacgaaacacggaaaccgaagaccattcatgttgttgctcaggtcgcagacgttttgcagcagcagtcgcttcacgttcgctcgcgtatcggtgattcattctgctaaccagtaaggcaaccccgccagcctagccgggtcctcaacgacaggagcacgatcatgcgcacccgtggccaggacccaacgctgcccgagatgcgccgcgtgcggctgctggagatggcggacgcgatggatatgttctgccaagggttggtttgcgcattcacagttctccgcaagaattgattggctccaattcttggagtggtgaatccgttagcgaggtgccgccggcttccattcaggtcgaggtggcccggctccatgcaccgcgacgcaacgcggggaggcagacaaggtatagggcggcgcctacaatccatgccaacccgttccatgtgctcgccgaggcggcataaatcgccgtgacgatcagcggtccagtgatcgaagttaggctggtaagagccgcgagcgatccttgaagctgtccctgatggtcgtcatctacctgcctggacagcatggcctgcaacgcgggcatcccgatgccgccggaagcgagaagaatcataatggggaaggccatccagcctcgcgtcgcgaacgccagcaagacgtagcccagcgcgtcggccgccatgccggcgataatggcctgcttctcgccgaaacgtttggtggcgggaccagtgacgaaggcttgagcgagggcgtgcaagattccgaataccgcaagcgacaggccgatcatcgtcgcgctccagcgaaagcggtcctcgccgaaaatgacccagagcgctgccggcacctgtcctacgagttgcatgataaagaagacagtcataagtgcggcgacgatagtcatgccccgcgcccaccggaaggagctgactgggttgaaggctctcaagggcatcggtcgacgctctcccttatgcgactcctgcattaggaagcagcccagtagtaggttgaggccgttgagcaccgccgccgcaaggaatggtgcatgcaaggagatggcgcccaacagtcccccggccacggggcctgccaccatacccacgccgaaacaagcgctcatgagcccgaagtggcgagcccgatcttccccatcggtgatgtcggcgatataggcgccagcaaccgcacctgtggcgccggtgatgccggccacgatgcgtccggcgtagaggattcacaggacgggtgtggtcgccatgatcgcgtagtcgatagtggctccaagtagcgaagcgagcaggactgggcggcggccaaagcggtcggacagtgctccgagaacgggtgcgcatagaaattgcatcaacgcatatagcgctagcagcacgccatagtgactggcgatgctgtcggaatggacgatatcccgcaagaggcccggcagtaccggcataaccaagcctatgcctacagcatccagggtgacggtgccgaggatgacgatgagcgcattgttagatttcatacacggtgcctgactgcgttagcaatttaactgtgataaactaccgcattaaagcttatcgatgataagctgtcaaacatgagaa pBR-CBST-CTX-M-15 SEQ ID 7ttcttgaagacgaaagggcctcgtgatacgcctatttttataggttaatgtcatgataataatggtttcttagacgtcaggtggcacttttcggggaaatgtgcgcggaacccctatttgtttatttttctaaatacattcaaatatgtatccgctcatgagacaataaccctgataaatgcttcaataatattgaaaaaggaagagtcatATGGAATCTGTTAAATCAGCGAGTTGAGATCAAAAAATCTGACCTTGTTAACTATAATCCGATTGCGGAAAAGCACGTCAATGGGACGATGTCACTGGCTGAGCTTAGCGCGGCCGCGCTACAGTACAGCGATAACGTGGCGATGAATAAGCTGATTGCTCACGTTGGCGGCCCGGCTAGCGTCACCGCGTTCGCCCGACAGCTGGGAGACGAAACGTTCCGTCTCGACCGTACCGAGCCGACGTTAAACACCGCCATTCCGGGCGATCCGCGTGATACCACTTCACCTCGGGCAATGGCGCAAACTCTGCGGAATCTGACGCTGGGTAAAGCATTGGGGGACAGCCAACGGGCGCAGCTGGTGACATGGATGAAAGGCAATACCACCGGTGCAGCGAGCATTCAGGCTGGACTGCCTGCTTCCTGGGTTGTGGGGGATAAAACCGGCAGCGGTGGCTATGGCACCACCAACGATATCGCGGTGATCTGGCCAAAAGATCGTGCGCCGCTGATTCTGGTCACTTACTTCACCCAGCCTCAACCTAAGGCAGAAAGCCGTCGCGATGTATTAGCGTCGGCGGCTAAAATCGTCACCGACGGTTTGTAAggatccctgtcagaccaagtttactcatatatactttagattgatttaaaacttcatttttaatttaaaaggatctaggtgaagatcctttttgataatctcatgaccaaaatcccttaacgtgagttttcgttccactgagcgtcagaccccgtagaaaagatcaaaggatcttcttgagatcctttttttctgcgcgtaatctgctgcttgcaaacaaaaaaaccaccgctaccagcggtggtttgtttgccggatcaagagctaccaactctttttccgaaggtaactggcttcagcagagcgcagataccaaatactgtccttctagtgtagccgtagttaggccaccacttcaagaactctgtagcaccgcctacatacctcgctctgctaatcctgttaccagtggctgctgccagtggcgataagtcgtgtcttaccgggttggactcaagacgatagttaccggataaggcgcagcggtcgggctgaacggggggttcgtgcacacagcccagcttggagcgaacgacctacaccgaactgagatacctacagcgtgagctatgagaaagcgccacgcttcccgaagggagaaaggcggacaggtatccggtaagcggcagggtcggaacaggagagcgcacgagggagcttccagggggaaacgcctggtatctttatagtcctgtcgggtttcgccacctctgacttgagcgtcgatttttgtgatgctcgtcaggggggcggagcctatggaaaaacgccagcaacgcggcctttttacggttcctggccttttgctggccttttgctcacatgttctttcctgcgttatcccctgattctgtggataaccgtattaccgcctttgagtgagctgataccgctcgccgcagccgaacgaccgagcgcagcgagtcagtgagcgaggaagcggaagagcgcctgatgcggtattttctccttacgcatctgtgcggtatttcacaccgcatttggtgcactctcagtacaatctgctctgatgccgcatagttaagccagtatacactccgctatcgctacgtgactgggtcatggctgcgccccgacacccgccaacacccgctgacgcgccctgacgggcttgtctgctcccggcatccgcttacagacaagctgtgaccgtctccgggagctgcatgtgtcagaggttttcaccgtcatcaccgaaacgcgcgaggcagctgcggtaaagctcatcagcgtggtcgtgaagcgattcacagatgtctgcctgttcatccgcgtccagctcgttgagtttctccagaagcgttaatgtctggcttctgataaagcgggccatgttaagggcggttttttcctgtttggtcactgatgcctccgtgtaagggggatttctgttcatgggggtaatgataccgatgaaacgagagaggatgctcacgatacgggttactgatgatgaacatgcccggttactggaacgttgtgagggtaaacaactggcggtatggatgcggcgggaccagagaaaaatcactcagggtcaatgccagcgcttcgttaatacagatgtaggtgttccacagggtagccagcagcatcctgcgatgcagatccggaacataatggtgcagggcgctgacttccgcgtttccagactttacgaaacacggaaaccgaagaccattcatgttgttgctcaggtcgcagacgttttgcagcagcagtcgcttcacgttcgctcgcgtatcggtgattcattctgctaaccagtaaggcaaccccgccagcctagccgggtcctcaacgacaggagcacgatcatgcgcacccgtggccaggacccaacgctgcccgagatgcgccgcgtgcggctgctggagatggcggacgcgatggatatgttctgccaagggttggtttgcgcattcacagttctccgcaagaattgattggctccaattcttggagtggtgaatccgttagcgaggtgccgccggcttccattcaggtcgaggtggcccggctccatgcaccgcgacgcaacgcggggaggcagacaaggtatagggcggcgcctacaatccatgccaacccgttccatgtgctcgccgaggcggcataaatcgccgtgacgatcagcggtccagtgatcgaagttaggctggtaagagccgcgagcgatccttgaagctgtccctgatggtcgtcatctacctgcctggacagcatggcctgcaacgcgggcatcccgatgccgccggaagcgagaagaatcataatggggaaggccatccagcctcgcgtcgcgaacgccagcaagacgtagcccagcgcgtcggccgccatgccggcgataatggcctgcttctcgccgaaacgtttggtggcgggaccagtgacgaaggcttgagcgagggcgtgcaagattccgaataccgcaagcgacaggccgatcatcgtcgcgctccagcgaaagcggtcctcgccgaaaatgacccagagcgctgccggcacctgtcctacgagttgcatgataaagaagacagtcataagtgcggcgacgatagtcatgccccgcgcccaccggaaggagctgactgggttgaaggctctcaagggcatcggtcgacgctctcccttatgcgactcctgcattaggaagcagcccagtagtaggttgaggccgttgagcaccgccgccgcaaggaatggtgcatgcaaggagatggcgcccaacagtcccccggccacggggcctgccaccatacccacgccgaaacaagcgctcatgagcccgaagtggcgagcccgatcttccccatcggtgatgtcggcgatataggcgccagcaaccgcacctgtggcgccggtgatgccggccacgatgcgtccggcgtagaggattcacaggacgggtgtggtcgccatgatcgcgtagtcgatagtggctccaagtagcgaagcgagcaggactgggcggcggccaaagcggtcggacagtgctccgagaacgggtgcgcatagaaattgcatcaacgcatatagcgctagcagcacgccatagtgactggcgatgctgtcggaatggacgatatcccgcaagaggcccggcagtaccggcataaccaagcctatgcctacagcatccagggtgacggtgccgaggatgacgatgagcgcattgttagatttcatacacggtgcctgactgcgttagcaatttaactgtgataaactaccgcattaaagcttatcgatgataagctgtcaaacatgagaapBR-CBST-SHV-12 SEQ ID 8ttcttgaagacgaaagggcctcgtgatacgcctatttttataggttaatgtcatgataataatggtttcttagacgtcaggtggcacttttcggggaaatgtgcgcggaacccctatttgtttatttttctaaatacattcaaatatgtatccgctcatgagacaataaccctgataaatgcttcaataatattgaaaaaggaagagtcatATGCGTTATATTCGCCTGTGTATTATCTCCCTGTTAGCCACCCTGCCGCTGGCGGTACACGCCAGCCCGCAGCCGCTTGAGCAAATTAAACAAAGCGAAAGCCAGCTGTCGGGCCGCGTAGGCATGATAGAAATGGATCTGGCCAGCGGCCGCACGCTGACCGCCTGGCGCGCCGATGAACGCTTTCCCATGATGAGCACCTTTAAAGTAGTGCTCTGCGGCGCAGTGCTGGCGCGGGTGGATGCCGGTGACGAACAGCTGGAGCGAAAGATCCACTATCGCCAGCAGGATCTGGTGGACTACTCGCCGGTCAGCGAAAAACACCTTGCCGACGGCATGACGGTCGGCGAACTCTGCGCCGCCGCCATTACCATGAGCGATAACAGCGCCGCCAATCTGCTGCTGGCCACCGTCGGCGGCCCCGCAGGATTGACTGCCTTTTTGCGCCAGATCGGCGACAACGTCACCCGCCTTGACCGCTGGGAAACGGAACTGAATGAGGCGCTTCCCGGCGACGCCCGCGACACCACTACCCCGGCCAGCATGGCCGCGACCCTGCGCAAGCTGCTGACCAGCCAGCGTCTGAGCGCCCGTTCGCAACGGCAGCTGCTGCAGTGGATGGTGGACGATCGGGTCGCCGGACCGTTGATCCGCTCCGTGCTGCCGGCGGGCTGGTTTATCGCCGATAAGACCGGAGCTAGCAAGCGGGGTGCGCGCGGGATTGTCGCCCTGCTTGGCCCGAATAACAAAGCAGAGCGCATTGTGGTGATTTATCTGCGGGATACCCCGGCGAGCATGGCCGAGCGAAATCAGCAAATCGCCGGGATCGGCGCGGCGCTGATCGAGCACTGGCAACGCTAAggatccctgtcagaccaagtttactcatatatactttagattgatttaaaacttcatttttaatttaaaaggatctaggtgaagatcctttttgataatctcatgaccaaaatcccttaacgtgagttttcgttccactgagcgtcagaccccgtagaaaagatcaaaggatcttcttgagatcctttttttctgcgcgtaatctgctgcttgcaaacaaaaaaaccaccgctaccagcggtggtttgtttgccggatcaagagctaccaactctttttccgaaggtaactggcttcagcagagcgcagataccaaatactgtccttctagtgtagccgtagttaggccaccacttcaagaactctgtagcaccgcctacatacctcgctctgctaatcctgttaccagtggctgctgccagtggcgataagtcgtgtcttaccgggttggactcaagacgatagttaccggataaggcgcagcggtcgggctgaacggggggttcgtgcacacagcccagcttggagcgaacgacctacaccgaactgagatacctacagcgtgagctatgagaaagcgccacgcttcccgaagggagaaaggcggacaggtatccggtaagcggcagggtcggaacaggagagcgcacgagggagcttccagggggaaacgcctggtatctttatagtcctgtcgggtttcgccacctctgacttgagcgtcgatttttgtgatgctcgtcaggggggcggagcctatggaaaaacgccagcaacgcggcctttttacggttcctggccttttgctggccttttgctcacatgttctttcctgcgttatcccctgattctgtggataaccgtattaccgcctttgagtgagctgataccgctcgccgcagccgaacgaccgagcgcagcgagtcagtgagcgaggaagcggaagagcgcctgatgcggtattttctccttacgcatctgtgcggtatttcacaccgcatttggtgcactctcagtacaatctgctctgatgccgcatagttaagccagtatacactccgctatcgctacgtgactgggtcatggctgcgccccgacacccgccaacacccgctgacgcgccctgacgggcttgtctgctcccggcatccgcttacagacaagctgtgaccgtctccgggagctgcatgtgtcagaggttttcaccgtcatcaccgaaacgcgcgaggcagctgcggtaaagctcatcagcgtggtcgtgaagcgattcacagatgtctgcctgttcatccgcgtccagctcgttgagtttctccagaagcgttaatgtctggcttctgataaagcgggccatgttaagggcggttttttcctgtttggtcactgatgcctccgtgtaagggggatttctgttcatgggggtaatgataccgatgaaacgagagaggatgctcacgatacgggttactgatgatgaacatgcccggttactggaacgttgtgagggtaaacaactggcggtatggatgcggcgggaccagagaaaaatcactcagggtcaatgccagcgcttcgttaatacagatgtaggtgttccacagggtagccagcagcatcctgcgatgcagatccggaacataatggtgcagggcgctgacttccgcgtttccagactttacgaaacacggaaaccgaagaccattcatgttgttgctcaggtcgcagacgttttgcagcagcagtcgcttcacgttcgctcgcgtatcggtgattcattctgctaaccagtaaggcaaccccgccagcctagccgggtcctcaacgacaggagcacgatcatgcgcacccgtggccaggacccaacgctgcccgagatgcgccgcgtgcggctgctggagatggcggacgcgatggatatgttctgccaagggttggtttgcgcattcacagttctccgcaagaattgattggctccaattcttggagtggtgaatccgttagcgaggtgccgccggcttccattcaggtcgaggtggcccggctccatgcaccgcgacgcaacgcggggaggcagacaaggtatagggcggcgcctacaatccatgccaacccgttccatgtgctcgccgaggcggcataaatcgccgtgacgatcagcggtccagtgatcgaagttaggctggtaagagccgcgagcgatccttgaagctgtccctgatggtcgtcatctacctgcctggacagcatggcctgcaacgcgggcatcccgatgccgccggaagcgagaagaatcataatggggaaggccatccagcctcgcgtcgcgaacgccagcaagacgtagcccagcgcgtcggccgccatgccggcgataatggcctgcttctcgccgaaacgtttggtggcgggaccagtgacgaaggcttgagcgagggcgtgcaagattccgaataccgcaagcgacaggccgatcatcgtcgcgctccagcgaaagcggtcctcgccgaaaatgacccagagcgctgccggcacctgtcctacgagttgcatgataaagaagacagtcataagtgcggcgacgatagtcatgccccgcgcccaccggaaggagctgactgggttgaaggctctcaagggcatcggtcgacgctctcccttatgcgactcctgcattaggaagcagcccagtagtaggttgaggccgttgagcaccgccgccgcaaggaatggtgcatgcaaggagatggcgcccaacagtcccccggccacggggcctgccaccatacccacgccgaaacaagcgctcatgagcccgaagtggcgagcccgatcttccccatcggtgatgtcggcgatataggcgccagcaaccgcacctgtggcgccggtgatgccggccacgatgcgtccggcgtagaggattcacaggacgggtgtggtcgccatgatcgcgtagtcgatagtggctccaagtagcgaagcgagcaggactgggcggcggccaaagcggtcggacagtgctccgagaacgggtgcgcatagaaattgcatcaacgcatatagcgctagcagcacgccatagtgactggcgatgctgtcggaatggacgatatcccgcaagaggcccggcagtaccggcataaccaagcctatgcctacagcatccagggtgacggtgccgaggatgacgatgagcgcattgttagatttcatacacggtgcctgactgcgttagcaatttaactgtgataaactaccgcattaaagcttatcgatgataagctgtcaaacatgagaapBR-CBST-P99 SEQ ID 9ttcttgaagacgaaagggcctcgtgatacgcctatttttataggttaatgtcatgataataatggtttcttagacgtcaggtggcacttttcggggaaatgtgcgcggaacccctatttgtttatttttctaaatacattcaaatatgtatccgctcatgagacaataaccctgataaatgcttcaataatattgaaaaaggaagagtcatATGATGAGAAAATCCCTTTGCTGCGCCCTGCTGCTCGGCATCTCTTGCTCTGCTCTCGCCACGCCAGTGTCAGAAAAACAGCTGGCGGAGGTGGTCGCGAATACGATTACCCCGCTGATGAAAGCCCAGTCTGTTCCAGGCATGGCGGTGGCCGTTATTTATCAGGGAAAACCGCACTATTACACATTTGGCAAGGCCGATATCGCGGCGAATAAACCCGTTACGCCTCAGACCCTGTTCGAGCTGGGTTCTATAAGTAAAACCTTCACCGGCGTTTTAGGTGGGGATGCCATTGCTCGCGGTGAAATTTCGCTGGACGATGCGGTGACCAGATACTGGCCACAGCTGACGGGCAAGCAGTGGCAGGGTATTCGTATGCTGGATCTCGCCACCTACACCGCTGGCGGCCTGCCGCTACAGGTACCGGATGAGGTCACGGATAACGCCTCCCTGCTGCGCTTTTATCAAAACTGGCAGCCGCAGTGGAAGCCTGGCACAACGCGTCTTTACGCCAACGCCAGCATCGGTCTTTTTGGTGCGCTGGCGGTCAAACCTTCTGGCATGCCCTATGAGCAGGCCATGACGACGCGGGTCCTTAAGCCGCTCAAGCTGGACCATACCTGGATTAACGTGCCGAAAGCGGAAGAGGCGCATTACGCCTGGGGCTATCGTGACGGTAAAGCGGTGCGCGTTTCGCCGGGTATGCTGGATGCACAAGCCTATGGCGTGAAAACCAACGTGCAGGATATGGCGAACTGGGTCATGGCAAACATGGCGCCGGAGAACGTTGCTGATGCCTCACTTAAGCAGGGCATCGCGCTGGCGCAGTCGCGCTACTGGCGTATCGGGTCAATGTATCAGGGTCTGGGCTGGGAGATGCTCAACTGGCCCGTGGAGGCCAACACGGTGGTCGAGGGCAGCGACAGTAAGGTAGCACTGGCGCCGTTGCCCGTGGCAGAAGTGAATCCACCGGCTCCCCCGGTCAAAGCGTCCTGGGTCCATAAAACGGGCTCTACTGGCGGGTTTGGCAGCTACGTGGCCTTTATTCCTGAAAAGCAGATCGGTATTGTGATGCTCGCGAATACAAGCTATCCGAACCCGGCACGCGTTGAGGCGGCATACCATATCCTCGAGGCGCTACAGTAAggatccctgtcagaccaagtttactcatatatactttagattgatttaaaacttcatttttaatttaaaaggatctaggtgaagatcctttttgataatctcatgaccaaaatcccttaacgtgagttttcgttccactgagcgtcagaccccgtagaaaagatcaaaggatcttcttgagatcctttttttctgcgcgtaatctgctgcttgcaaacaaaaaaaccaccgctaccagcggtggtttgtttgccggatcaagagctaccaactctttttccgaaggtaactggcttcagcagagcgcagataccaaatactgtccttctagtgtagccgtagttaggccaccacttcaagaactctgtagcaccgcctacatacctcgctctgctaatcctgttaccagtggctgctgccagtggcgataagtcgtgtcttaccgggttggactcaagacgatagttaccggataaggcgcagcggtcgggctgaacggggggttcgtgcacacagcccagcttggagcgaacgacctacaccgaactgagatacctacagcgtgagctatgagaaagcgccacgcttcccgaagggagaaaggcggacaggtatccggtaagcggcagggtcggaacaggagagcgcacgagggagcttccagggggaaacgcctggtatctttatagtcctgtcgggtttcgccacctctgacttgagcgtcgatttttgtgatgctcgtcaggggggcggagcctatggaaaaacgccagcaacgcggcctttttacggttcctggccttttgctggccttttgctcacatgttctttcctgcgttatcccctgattctgtggataaccgtattaccgcctttgagtgagctgataccgctcgccgcagccgaacgaccgagcgcagcgagtcagtgagcgaggaagcggaagagcgcctgatgcggtattttctccttacgcatctgtgcggtatttcacaccgcatttggtgcactctcagtacaatctgctctgatgccgcatagttaagccagtatacactccgctatcgctacgtgactgggtcatggctgcgccccgacacccgccaacacccgctgacgcgccctgacgggcttgtctgctcccggcatccgcttacagacaagctgtgaccgtctccgggagctgcatgtgtcagaggttttcaccgtcatcaccgaaacgcgcgaggcagctgcggtaaagctcatcagcgtggtcgtgaagcgattcacagatgtctgcctgttcatccgcgtccagctcgttgagtttctccagaagcgttaatgtctggcttctgataaagcgggccatgttaagggcggttttttcctgtttggtcactgatgcctccgtgtaagggggatttctgttcatgggggtaatgataccgatgaaacgagagaggatgctcacgatacgggttactgatgatgaacatgcccggttactggaacgttgtgagggtaaacaactggcggtatggatgcggcgggaccagagaaaaatcactcagggtcaatgccagcgcttcgttaatacagatgtaggtgttccacagggtagccagcagcatcctgcgatgcagatccggaacataatggtgcagggcgctgacttccgcgtttccagactttacgaaacacggaaaccgaagaccattcatgttgttgctcaggtcgcagacgttttgcagcagcagtcgcttcacgttcgctcgcgtatcggtgattcattctgctaaccagtaaggcaaccccgccagcctagtcgggtcctcaacgacaggagcacgatcatgcgcacccgtggccaggacccaacgctgcccgagatgcgccgcgtgcggctgctggagatggcggacgcgatggatatgttctgccaagggttggtttgcgcattcacagttctccgcaagaattgattggctccaattcttggagtggtgaatccgttagcgaggtgccgccggcttccattcaggtcgaggtggcccggctccatgcaccgcgacgcaacgcggggaggcagacaaggtatagggcggcgcctacaatccatgccaacccgttccatgtgctcgccgaggcggcataaatcgccgtgacgatcagcggtccagtgatcgaagttaggctggtaagagccgcgagcgatccttgaagctgtccctgatggtcgtcatctacctgcctggacagcatggcctgcaacgcgggcatcccgatgccgccggaagcgagaagaatcataatggggaaggccatccagcctcgcgtcgcgaacgccagcaagacgtagcccagcgcgtcggccgccatgccggcgataatggcctgcttctcgccgaaacgtttggtggcgggaccagtgacgaaggcttgagcgagggcgtgcaagattccgaataccgcaagcgacaggccgatcatcgtcgcgctccagcgaaagcggtcctcgccgaaaatgacccagagcgctgccggcacctgtcctacgagttgcatgataaagaagacagtcataagtgcggcgacgatagtcatgccccgcgcccaccggaaggagctgactgggttgaaggctctcaagggcatcggtcgacgctctcccttatgcgactcctgcattaggaagcagcccagtagtaggttgaggccgttgagcaccgccgccgcaaggaatggtgcatgcaaggagatggcgcccaacagtcccccggccacggggcctgccaccatacccacgccgaaacaagcgctcatgagcccgaagtggcgagcccgatcttccccatcggtgatgtcggcgatataggcgccagcaaccgcacctgtggcgccggtgatgccggccacgatgcgtccggcgtagaggattcacaggacgggtgtggtcgccatgatcgcgtagtcgatagtggctccaagtagcgaagcgagcaggactgggcggcggccaaagcggtcggacagtgctccgagaacgggtgcgcatagaaattgcatcaacgcatatagcgctagcagcacgccatagtgactggcgatgctgtcggaatggacgatatcccgcaagaggcccggcagtaccggcataaccaagcctatgcctacagcatccagggtgacggtgccgaggatgacgatgagcgcattgttagatttcatacacggtgcctgactgcgttagcaatttaactgtgataaactaccgcattaaagcttatcgatgataagctgtcaaacatgagaa pBR-CBST-OXA-15 SEQ ID 10ttcttgaagacgaaagggcctcgtgatacgcctatttttataggttaatgtcatgataataatggtttcttagacgtcaggtggcacttttcggggaaatgtgcgcggaacccctatttgtttatttttctaaatacattcaaatatgtatccgctcatgagacaataaccctgataaatgcttcaataatattgaaaaaggaagagtcatATGGCAATCCGAATCTTCGCGATACTTTTCTCCATTTTTTCTCTTGCCACTTTCGCGCATGCGCAAGAAGGCACGCTAGAACGTTCTGACTGGAGGAAGTTTTTCAGCGAATTTCAAGCCAAAGGCACGATAGTTGTGGCAGACGAACGCCAAGCGGATCGTGCCATGTTGGTTTTTGATCCTGTGCGATCGAAGAAACGCTACTCGCCTGCATCGACATTCAAGATACCTCATACACTTTTTGCACTTGATGCAGGCGCTGTTCGTGATGAGTTCCAGATTTTTCGATGGGACGGCGTTAACAGGGGCTTTGCAGGCCACAATCAAGACCAAGATTTGCGATCAGCAATGCGGAATTCTACTGTTTGGGTGTATGAGCTATTTGCAAAGGAAATTGGTGATGACAAAGCTCGGCGCTATTTGAAGAAAATCGACTATGGCAACGCCGGTCCTTCGACAAGTAATGGCGATTACTGGATAGAAGGCAGCCTTGCAATCTCGGCGCAGGAGCAAATTGCATTTCTCAGGAAGCTCTATCGTAACGAGCTGCCCTTTCGGGTAGAACATCAGCGCTTGGTCAAGGATCTCATGATTGTGGAAGCCGGTCGCAACTGGATACTGCGTGCAAAGACGGGCTGGGAAGGCCGTATGGGTTGGTGGGTAGGATGGGTTGAGTGGCCGACTGGCTCCGTATTCTTCGCACTGAATATTGATACGCCAAACAGAATGGATGATCTTTTCAAGAGGGAGGCAATCGTGCGGGCAATCCTTCGCTCTATTGAAGCGTTACCGCCCAACCCGGCAGTCAACTCGGACGCTGCGCGATAAggatccctgtcagaccaagtttactcatatatactttagattgatttaaaacttcatttttaatttaaaaggatctaggtgaagatcctttttgataatctcatgaccaaaatcccttaacgtgagttttcgttccactgagcgtcagaccccgtagaaaagatcaaaggatcttcttgagatcctttttttctgcgcgtaatctgctgcttgcaaacaaaaaaaccaccgctaccagcggtggtttgtttgccggatcaagagctaccaactctttttccgaaggtaactggcttcagcagagcgcagataccaaatactgtccttctagtgtagccgtagttaggccaccacttcaagaactctgtagcaccgcctacatacctcgctctgctaatcctgttaccagtggctgctgccagtggcgataagtcgtgtcttaccgggttggactcaagacgatagttaccggataaggcgcagcggtcgggctgaacggggggttcgtgcacacagcccagcttggagcgaacgacctacaccgaactgagatacctacagcgtgagctatgagaaagcgccacgcttcccgaagggagaaaggcggacaggtatccggtaagcggcagggtcggaacaggagagcgcacgagggagcttccagggggaaacgcctggtatctttatagtcctgtcgggtttcgccacctctgacttgagcgtcgatttttgtgatgctcgtcaggggggcggagcctatggaaaaacgccagcaacgcggcctttttacggttcctggccttttgctggccttttgctcacatgttctttcctgcgttatcccctgattctgtggataaccgtattaccgcctttgagtgagctgataccgctcgccgcagccgaacgaccgagcgcagcgagtcagtgagcgaggaagcggaagagcgcctgatgcggtattttctccttacgcatctgtgcggtatttcacaccgcatttggtgcactctcagtacaatctgctctgatgccgcatagttaagccagtatacactccgctatcgctacgtgactgggtcatggctgcgccccgacacccgccaacacccgctgacgcgccctgacgggcttgtctgctcccggcatccgcttacagacaagctgtgaccgtctccgggagctgcatgtgtcagaggttttcaccgtcatcaccgaaacgcgcgaggcagctgcggtaaagctcatcagcgtggtcgtgaagcgattcacagatgtctgcctgttcatccgcgtccagctcgttgagtttctccagaagcgttaatgtctggcttctgataaagcgggccatgaaagggcggttttttcctgtttggtcactgatgcctccgtgtaagggggatttctgttcatgggggtaatgataccgatgaaacgagagaggatgctcacgatacgggttactgatgatgaacatgcccggttactggaacgttgtgagggtaaacaactggcggtatggatgcggcgggaccagagaaaaatcactcagggtcaatgccagcgcttcgttaatacagatgtaggtgttccacagggtagccagcagcatcctgcgatgcagatccggaacataatggtgcagggcgctgacttccgcgtttccagactttacgaaacacggaaaccgaagaccattcatgttgttgctcaggtcgcagacgttttgcagcagcagtcgcttcacgttcgctcgcgtatcggtgattcattctgctaaccagtaaggcaaccccgccagcctagccgggtcctcaacgacaggagcacgatcatgcgcacccgtggccaggacccaacgctgcccgagatgcgccgcgtgcggctgctggagatggcggacgcgatggatatgttctgccaagggttggtttgcgcattcacagttctccgcaagaattgattggctccaattcttggagtggtgaatccgttagcgaggtgccgccggcttccattcaggtcgaggtggcccggctccatgcaccgcgacgcaacgcggggaggcagacaaggtatagggcggcgcctacaatccatgccaacccgttccatgtgctcgccgaggcggcataaatcgccgtgacgatcagcggtccagtgatcgaagttaggctggtaagagccgcgagcgatccttgaagctgtccctgatggtcgtcatctacctgcctggacagcatggcctgcaacgcgggcatcccgatgccgccggaagcgagaagaatcataatggggaaggccatccagcctcgcgtcgcgaacgccagcaagacgtagcccagcgcgtcggccgccatgccggcgataatggcctgcttctcgccgaaacgtttggtggcgggaccagtgacgaaggcttgagcgagggcgtgcaagattccgaataccgcaagcgacaggccgatcatcgtcgcgctccagcgaaagcggtcctcgccgaaaatgacccagagcgctgccggcacctgtcctacgagttgcatgataaagaagacagtcataagtgcggcgacgatagtcatgccccgcgcccaccggaaggagctgactgggttgaaggctctcaagggcatcggtcgacgctctcccttatgcgactcctgcattaggaagcagcccagtagtaggttgaggccgttgagcaccgccgccgcaaggaatggtgcatgcaaggagatggcgcccaacagtcccccggccacggggcctgccaccatacccacgccgaaacaagcgctcatgagcccgaagtggcgagcccgatcttccccatcggtgatgtcggcgatataggcgccagcaaccgcacctgtggcgccggtgatgccggccacgatgcgtccggcgtagaggattcacaggacgggtgtggtcgccatgatcgcgtagtcgatagtggctccaagtagcgaagcgagcaggactgggcggcggccaaagcggtcggacagtgctccgagaacgggtgcgcatagaaattgcatcaacgcatatagcgctagcagcacgccatagtgactggcgatgctgtcggaatggacgatatcccgcaagaggcccggcagtaccggcataaccaagcctatgcctacagcatccagggtgacggtgccgaggatgacgatgagcgcattgttagatttcatacacggtgcctgactgcgttagcaatttaactgtgataaactaccgcattaaagcttatcgatgataagctgtcaaacatgagaa pBR-CBST-KPC-4 SEQ ID 11ttcttgaagacgaaagggcctcgtgatacgcctatttttataggttaatgtcatgataataatggtttcttagacgtcaggtggcacttttcggggaaatgtgcgcggaacccctatttgtttatttttctaaatacattcaaatatgtatccgctcatgagacaataaccctgataaatgcttcaataatattgaaaaaggaagagtcatATGTCACTGTATCGCCGTCTAGTTCTGCTGTCTTGTCTCTCATGGCCGCTGGCTGGCTTTTCTGCCACCGCGCTGACCAACCTCGTCGCGGAACCATTCGCTAAACTCGAACAGGACTTTGGCGGCTCCATCGGTGTGTACGCGATGGATACCGGCTCAGGCGCAACTGTAAGTTACCGCGCTGAGGAGCGCTTCCCACTGTGCAGCTCATTCAAGGGCTTTCTTGCTGCCGCTGTGCTGGCTCGCAGCCAGCAGCAGGCCGGCTTGCTGGACACACCCATCCGTTACGGCAAAAATGCGCTGGTTCGGTGGTCACCCATCTCGGAAAAATATCTGACAACAGGCATGACGGTGGCGGAGCTGTCCGCGGCCGCCGTGCAATACAGTGATAACGCCGCCGCCAATTTGTTGCTGAAGGAGTTGGGCGGCCCGGCCGGGCTGACGGCCTTCATGCGCTCTATCGGCGATACCACGTTCCGTCTGGACCGCTGGGAGCTGGAGCTGAACTCCGCCATCCCAGGCGATGCGCGCGATACCTCATCGCCGCGCGCCGTGACGGAAAGCTTACAAAAACTGACACTGGGCTCTGCACTGGCTGCGCCGCAGCGGCAGCAGTTTGTTGATTGGCTAAAGGGAAACACGACCGGCAACCACCGCATCCGCGCGGCGGTGCCGGCAGACTGGGCAGTCGGAGACAAAACCGGAACCTGCGGAGGGTATGGCACGGCAAATGACTATGCCGTCGTCTGGCCCACTGGGCGCGCACCTATTGTGTTGGCCGTCTACACCCGGGCGCCTAACAAGGATGACAAGCACAGCGAGGCCGTCATCGCCGCTGCGGCTAGACTCGCGCTCGAGGGATTGGGCGTCAACGGGCAGTAAggatccctgtcagaccaagtttactcatatatactttagattgatttaaaacttcatttttaatttaaaaggatctaggtgaagatcctttttgataatctcatgaccaaaatcccttaacgtgagttttcgttccactgagcgtcagaccccgtagaaaagatcaaaggatcttcttgagatcctttttttctgcgcgtaatctgctgcttgcaaacaaaaaaaccaccgctaccagcggtggtttgtttgccggatcaagagctaccaactctttttccgaaggtaactggcttcagcagagcgcagataccaaatactgtccttctagtgtagccgtagttaggccaccacttcaagaactctgtagcaccgcctacatacctcgctctgctaatcctgttaccagtggctgctgccagtggcgataagtcgtgtcttaccgggttggactcaagacgatagttaccggataaggcgcagcggtcgggctgaacggggggttcgtgcacacagcccagcttggagcgaacgacctacaccgaactgagatacctacagcgtgagctatgagaaagcgccacgcttcccgaagggagaaaggcggacaggtatccggtaagcggcagggtcggaacaggagagcgcacgagggagcttccagggggaaacgcctggtatctttatagtcctgtcgggtttcgccacctctgacttgagcgtcgatttttgtgatgctcgtcaggggggcggagcctatggaaaaacgccagcaacgcggcctttttacggttcctggccttttgctggccttttgctcacatgttctttcctgcgttatcccctgattctgtggataaccgtattaccgcctttgagtgagctgataccgctcgccgcagccgaacgaccgagcgcagcgagtcagtgagcgaggaagcggaagagcgcctgatgcggtattttctccttacgcatctgtgcggtatttcacaccgcatttggtgcactctcagtacaatctgctctgatgccgcatagttaagccagtatacactccgctatcgctacgtgactgggtcatggctgcgccccgacacccgccaacacccgctgacgcgccctgacgggcttgtctgctcccggcatccgcttacagacaagctgtgaccgtctccgggagctgcatgtgtcagaggttttcaccgtcatcaccgaaacgcgcgaggcagctgcggtaaagctcatcagcgtggtcgtgaagcgattcacagatgtctgcctgttcatccgcgtccagctcgttgagtttctccagaagcgttaatgtctggcttctgataaagcgggccatgttaagggcggttttttcctgtttggtcactgatgcctccgtgtaagggggatttctgttcatgggggtaatgataccgatgaaacgagagaggatgctcacgatacgggttactgatgatgaacatgcccggttactggaacgttgtgagggtaaacaactggcggtatggatgcggcgggaccagagaaaaatcactcagggtcaatgccagcgcttcgttaatacagatgtaggtgttccacagggtagccagcagcatcctgcgatgcagatccggaacataatggtgcagggcgctgacttccgcgtttccagactttacgaaacacggaaaccgaagaccattcatgttgttgctcaggtcgcagacgttttgcagcagcagtcgcttcacgttcgctcgcgtatcggtgattcattctgctaaccagtaaggcaaccccgccagcctagccgggtcctcaacgacaggagcacgatcatgcgcacccgtggccaggacccaacgctgcccgagatgcgccgcgtgcggctgctggagatggcggacgcgatggatatgttctgccaagggttggtttgcgcattcacagttctccgcaagaattgattggctccaattcttggagtggtgaatccgttagcgaggtgccgccggcttccattcaggtcgaggtggcccggctccatgcaccgcgacgcaacgcggggaggcagacaaggtatagggcggcgcctacaatccatgccaacccgttccatgtgctcgccgaggcggcataaatcgccgtgacgatcagcggtccagtgatcgaagttaggctggtaagagccgcgagcgatccttgaagctgtccctgatggtcgtcatctacctgcctggacagcatggcctgcaacgcgggcatcccgatgccgccggaagcgagaagaatcataatggggaaggccatccagcctcgcgtcgcgaacgccagcaagacgtagcccagcgcgtcggccgccatgccggcgataatggcctgcttctcgccgaaacgtttggtggcgggaccagtgacgaaggcttgagcgagggcgtgcaagattccgaataccgcaagcgacaggccgatcatcgtcgcgctccagcgaaagcggtcctcgccgaaaatgacccagagcgctgccggcacctgtcctacgagttgcatgataaagaagacagtcataagtgcggcgacgatagtcatgccccgcgcccaccggaaggagctgactgggttgaaggctctcaagggcatcggtcgacgctctcccttatgcgactcctgcattaggaagcagcccagtagtaggttgaggccgttgagcaccgccgccgcaaggaatggtgcatgcaaggagatggcgcccaacagtcccccggccacggggcctgccaccatacccacgccgaaacaagcgctcatgagcccgaagtggcgagcccgatcttccccatcggtgatgtcggcgatataggcgccagcaaccgcacctgtggcgccggtgatgccggccacgatgcgtccggcgtagaggattcacaggacgggtgtggtcgccatgatcgcgtagtcgatagtggctccaagtagcgaagcgagcaggactgggcggcggccaaagcggtcggacagtgctccgagaacgggtgcgcatagaaattgcatcaacgcatatagcgctagcagcacgccatagtgactggcgatgctgtcggaatggacgatatcccgcaagaggcccggcagtaccggcataaccaagcctatgcctacagcatccagggtgacggtgccgaggatgacgatgagcgcattgttagatttcatacacggtgcctgactgcgttagcaatttaactgtgataaactaccgcattaaagcttatcgatgataagctgtcaaacatgagaa pBR-CBST-DHA-1 SEQ ID 12ttcttgaagacgaaagggcctcgtgatacgcctatttttataggttaatgtcatgataataatggtttcttagacgtcaggtggcacttttcggggaaatgtgcgcggaacccctatttgtttatttttctaaatacattcaaatatgtatccgctcatgagacaataaccctgataaatgcttcaataatattgaaaaaggaagagtcatATGAAAAAATCGTTATCTGCAACACTGATTTCCGCTCTGCTGGCGTTTTCCGCCCCGGGGTTTTCTGCCGCTGATAATGTCGCGGCGGTGGTGGACAGCACCATTAAACCGCTGATGGCACAGCAGGATATTCCCGGGATGGCGGTTGCCGTCTCCGTAAAGGGTAAGCCCTATTATTTCAATTATGGTTTTGCCGATATTCAGGCAAAACAGCCGGTCACTGAAAATACACTATTTGAGCTCGGATCTGTAAGTAAAACTTTCACAGGTGTGCTGGGTGCGGTTTCTGTGGCGAAAAAAGAGATGGCGCTGAATGATCCGGCGGCAAAATACCAGCCGGAGCTGGCTCTGCCGCAGTGGAAGGGGATCACATTGCTGGATCTGGCTACCTATACCGCAGGCGGACTGCCGTTACAGGTGCCGGATGCGGTAAAAAGCCGTGCGGATCTGCTGAATTTCTATCAGCAGTGGCAGCCGTCCCGGAAACCGGGCGATATGCGTCTGTATGCAAACAGCAGTATCGGCCTGTTTGGTGCTCTGACCGCAAACGCGGCGGGGATGCCGTATGAGCAGTTGCTGACTGCACGCATCCTGGCACCGCTGGGGTTATCTCACACCTTTATTACTGTGCCGGAAAGTGCGCAAAGCCAGTATGCGTACGGTTATAAAAACAAAAAACCGGTCCGCGTGTCGCCGGGACAGCTTGATGCGGAATCTTACGGCGTGAAATCCGCCTCAAAAGATATGCTGCGCTGGGCGGAAATGAATATGGAGCCGTCACGGGCCGGTAATGCGGATCTGGAAATGGCAATGTATCTCGCCCAGACCCGCTACTATAAAACCGCCGCGATTAACCAGGGGCTGGGCTGGGAAATGTATGACTGGCCGCAGCAGAAAGATATGATCATTAACGGTGTGACCAACGAGGTCGCATTGCAGCCGCATCCGGTAACAGACAACCAGGTTCAGCCGTATAACCGTGCTTCCTGGGTGCATAAAACGGGCGCAACAACTGGTTTCGGCGCCTATGTCGCCTTTATTCCGGAAAAACAGGTGGCGATTGTGATTCTGGCGAATAAAAACTACCCGAATACCGAAAGAGTCAAAGCTGCACAGGCTATTTTGAGTGCACTGGAATAAggatccctgtcagaccaagtttactcatatatactttagattgatttaaaacttcatttttaatttaaaaggatctaggtgaagatcctttttgataatctcatgaccaaaatcccttaacgtgagttttcgttccactgagcgtcagaccccgtagaaaagatcaaaggatcttcttgagatcctttttttctgcgcgtaatctgctgcttgcaaacaaaaaaaccaccgctaccagcggtggtttgtttgccggatcaagagctaccaactctttttccgaaggtaactggcttcagcagagcgcagataccaaatactgtccttctagtgtagccgtagttaggccaccacttcaagaactctgtagcaccgcctacatacctcgctctgctaatcctgttaccagtggctgctgccagtggcgataagtcgtgtcttaccgggttggactcaagacgatagttaccggataaggcgcagcggtcgggctgaacggggggttcgtgcacacagcccagcttggagcgaacgacctacaccgaactgagatacctacagcgtgagctatgagaaagcgccacgcttcccgaagggagaaaggcggacaggtatccggtaagcggcagggtcggaacaggagagcgcacgagggagcttccagggggaaacgcctggtatctttatagtcctgtcgggtttcgccacctctgacttgagcgtcgatttttgtgatgctcgtcaggggggcggagcctatggaaaaacgccagcaacgcggcctttttacggttcctggccttttgctggccttttgctcacatgttctttcctgcgttatcccctgattctgtggataaccgtattaccgcctttgagtgagctgataccgctcgccgcagccgaacgaccgagcgcagcgagtcagtgagcgaggaagcggaagagcgcctgatgcggtattttctccttacgcatctgtgcggtatttcacaccgcatttggtgcactctcagtacaatctgctctgatgccgcatagttaagccagtatacactccgctatcgctacgtgactgggtcatggctgcgccccgacacccgccaacacccgctgacgcgccctgacgggcttgtctgctcccggcatccgcttacagacaagctgtgaccgtctccgggagctgcatgtgtcagaggttttcaccgtcatcaccgaaacgcgcgaggcagctgcggtaaagctcatcagcgtggtcgtgaagcgattcacagatgtctgcctgttcatccgcgtccagctcgttgagtttctccagaagcgttaatgtctggcttctgataaagcgggccatgttaagggcggttttttcctgtttggtcactgatgcctccgtgtaagggggatttctgttcatgggggtaatgataccgatgaaacgagagaggatgctcacgatacgggttactgatgatgaacatgcccggttactggaacgttgtgagggtaaacaactggcggtatggatgcggcgggaccagagaaaaatcactcagggtcaatgccagcgcttcgttaatacagatgtaggtgttccacagggtagccagcagcatcctgcgatgcagatccggaacataatggtgcagggcgctgacttccgcgtttccagactttacgaaacacggaaaccgaagaccattcatgttgttgctcaggtcgcagacgttttgcagcagcagtcgcttcacgttcgctcgcgtatcggtgattcattctgctaaccagtaaggcaaccccgccagcctagccgggtcctcaacgacaggagcacgatcatgcgcacccgtggccaggacccaacgctgcccgagatgcgccgcgtgcggctgctggagatggcggacgcgatggatatgttctgccaagggttggtttgcgcattcacagttctccgcaagaattgattggctccaattcttggagtggtgaatccgttagcgaggtgccgccggcttccattcaggtcgaggtggcccggctccatgcaccgcgacgcaacgcggggaggcagacaaggtatagggcggcgcctacaatccatgccaacccgttccatgtgctcgccgaggcggcataaatcgccgtgacgatcagcggtccagtgatcgaagttaggctggtaagagccgcgagcgatccttgaagctgtccctgatggtcgtcatctacctgcctggacagcatggcctgcaacgcgggcatcccgatgccgccggaagcgagaagaatcataatgggaaggccatccagcctcgcgtcgcgaacgccagcaagacgtagcccagcgcgtcggccgccatgccggcgataatggcctgcttctcgccgaaacgtttggtggcgggaccagtgacgaaggcttgagcgagggcgtgcaagattccgaataccgcaagcgacaggccgatcatcgtcgcgctccagcgaaagcggtcctcgccgaaaatgacccagagcgctgccggcacctgtcctacgagttgcatgataaagaagacagtcataagtgcggcgacgatagtcatgccccgcgcccaccggaaggagctgactgggttgaaggctctcaagggcatcggtcgacgctctcccttatgcgactcctgcattaggaagcagcccagtagtaggttgaggccgttgagcaccgccgccgcaaggaatggtgcatgcaaggagatggcgcccaacagtcccccggccacggggcctgccaccatacccacgccgaaacaagcgctcatgagcccgaagtggcgagcccgatcttccccatcggtgatgtcggcgatataggcgccagcaaccgcacctgtggcgccggtgatgccggccacgatgcgtccggcgtagaggattcacaggacgggtgtggtcgccatgatcgcgtagtcgatagtggctccaagtagcgaagcgagcaggactgggcggcggccaaagcggtcggacagtgctccgagaacgggtgcgcatagaaattgcatcaacgcatatagcgctagcagcacgccatagtgactggcgatgctgtcggaatggacgatatcccgcaagaggcccggcagtaccggcataaccaagcctatgcctacagcatccagggtgacggtgccgaggatgacgatgagcgcattgttagatttcatacacggtgcctgactgcgttagcaatttaactgtgataaactaccgcattaaagcttatcgatgataagctgtcaaacatgagaa pBR-CBST-ADC-33 SEQ ID 13ttcttgaagacgaaagggcctcgtgatacgcctatttttataggttaatgtcatgataataatggtttcttagacgtcaggtggcacttttcggggaaatgtgcgcggaacccctatttgtttatttttctaaatacattcaaatatgtatccgctcatgagacaataaccctgataaatgcttcaataatattgaaaaaggaagagtcatATGCGATTTAAAAAAATTTCTTGTCTACTTTTATCCCCGCTTTTTATTTTTAGTACCTCAATTTATGCGGGCAATACACCAAAAGACCAAGAAATTAAAAAACTGGTAGATCAAAACTTTAAACCGTTATTAGAAAAATATGATGTGCCAGGTATGGCTGTGGGTGTTATTCAAAATAATAAAAAGTATGAAATGTATTATGGTCTTCAATCTGTTCAAGATAAAAAAGCCGTAAATAGCAGTACCATTTTTGAGCTAGGTTCTGTCAGTAAATTATTTACCGCGACAGCAGGTGGATATGCAAAAAATAAAGGAAAAATCTCTTTTGACGATACGCCTGGTAAATATTGGAAAGAACTAAAAAACACACCGATTGACCAAGTTAACTTACTTCAACTCGCGACGTATACAAGTGGTAACCTTGCCTTGCAGTTTCCAGATGAAGTAAAAACAGACCAACAAGTTTTAACTTTTTTCAAAGACTGGAAACCTAAAAACTCAATCGGTGAATACAGACAATATTCAAATCCAAGTATTGGCCTATTTGGAAAGGTTGTGGCTTTGTCTATGAATAAACCTTTTCGACCAAGTCTTAGAAAAAACAATTTTTCCGGCCCTTGGCTTAAAACATAGCTATGTAAATGTACCTAAGACCCAGATGCAAAACTATGCATTTGGTTATAACCAAGAAAATCAGCCGATTCGAGTTAACCGCGGCCCACTCGATGCCGCCCCTGCGTATGGCGTCAAATCGACACTACCCGACATGTTGAGTTTTATTCATGCCAACCTTAACCCACAGAAATATCCGGCTGATATTCAACGGGCAATTAATGAAACACATCAAGGGCGCTATCAAGTAAATACCATGTATCAGGCACTCGGTTGGGAAGAGTTTTCTTATCCGGCAACGTTACAAACTTTATTAGACAGTAATTCAGAACAGATTGTGATGAAACCTAATAAAGTGACTGCTATTTCAAAGGAACCTTCAGTTAAGATGTACCATAAAACTGGCTCAACCAACGGTTTCGGAACGTATGTAGTGTTTATTCCTAAAGAAAATATTGGCTTAGTCATGTTAACCAATAAACGTATTCCAAATGAAGAGCGCATTAAGGCAGCTTATGCTGTGCTGAATGCAATAAAGAAATAAggatccctgtcagaccaagtttactcatatatactttagattgatttaaaacttcatttttaatttaaaaggatctaggtgaagatcctttttgataatctcatgaccaaaatcccttaacgtgagttttcgttccactgagcgtcagaccccgtagaaaagatcaaaggatcttcttgagatcctttttttctgcgcgtaatctgctgcttgcaaacaaaaaaaccaccgctaccagcggtggtttgtttgccggatcaagagctaccaactctttttccgaaggtaactggcttcagcagagcgcagataccaaatactgtccttctagtgtagccgtagttaggccaccacttcaagaactctgtagcaccgcctacatacctcgctctgctaatcctgttaccagtggctgctgccagtggcgataagtcgtgtcttaccgggttggactcaagacgatagttaccggataaggcgcagcggtcgggctgaacggggggttcgtgcacacagcccagcttggagcgaacgacctacaccgaactgagatacctacagcgtgagctatgagaaagcgccacgcttcccgaagggagaaaggcggacaggtatccggtaagcggcagggtcggaacaggagagcgcacgagggagcttccagggggaaacgcctggtatctttatagtcctgtcgggtttcgccacctctgacttgagcgtcgatttttgtgatgctcgtcaggggggcggagcctatggaaaaacgccagcaacgcggcctttttacggttcctggccttttgctggccttttgctcacatgttctttcctgcgttatcccctgattctgtggataaccgtattaccgcctttgagtgagctgataccgctcgccgcagccgaacgaccgagcgcagcgagtcagtgagcgaggaagcggaagagcgcctgatgcggtattttctccttacgcatctgtgcggtatttcacaccgcatttggtgcactctcagtacaatctgctctgatgccgcatagttaagccagtatacactccgctatcgctacgtgactgggtcatggctgcgccccgacacccgccaacacccgctgacgcgccctgacgggcttgtctgctcccggcatccgcttacagacaagctgtgaccgtctccgggagctgcatgtgtcagaggttttcaccgtcatcaccgaaacgcgcgaggcagctgcggtaaagctcatcagcgtggtcgtgaagcgattcacagatgtctgcctgttcatccgcgtccagctcgttgagtttctccagaagcgttaatgtctggcttctgataaagcgggccatgttaagggcggttttttcctgtttggtcactgatgcctccgtgtaagggggatttctgttcatgggggtaatgataccgatgaaacgagagaggatgctcacgatacgggttactgatgatgaacatgcccggttactggaacgttgtgagggtaaacaactggcggtatggatgcggcgggaccagagaaaaatcactcagggtcaatgccagcgcttcgttaatacagatgtaggtgttccacagggtagccagcagcatcctgcgatgcagatccggaacataatggtgcagggcgctgacttccgcgtttccagactttacgaaacacggaaaccgaagaccattcatgttgttgctcaggtcgcagacgttttgcagcagcagtcgcttcacgttcgctcgcgtatcggtgattcattctgctaaccagtaaggcaaccccgccagcctagccgggtcctcaacgacaggagcacgatcatgcgcacccgtggccaggacccaacgctgcccgagatgcgccgcgtgcggctgctggagatggcggacgcgatggatatgttctgccaagggttggtttgcgcattcacagttctccgcaagaattgattggctccaattcttggagtggtgaatccgttagcgaggtgccgccggcttccattcaggtcgaggtggcccggctccatgcaccgcgacgcaacgcggggaggcagacaaaggtataggcggcgcctacaatccatgccaacccgttccatgtgctcgccgaggcggcataaatcgccgtgacgatcagcggtccagtgatcgaagttaggctggtaagagccgcgagcgatccttgaagctgtccctgatggtcgtcatctacctgcctggacagcatggcctgcaacgcgggcatcccgatgccgccggaagcgagaagaatcataatgggaaggccatccagcctcgcgtcgcgaacgccagcaagacgtagcccagcgcgtcggccgccatgccggcgataatggcctgcttctcgccgaaacgtttggtggcgggaccagtgacgaaggcttgagcgagggcgtgcaagattccgaataccgcaagcgacaggccgatcatcgtcgcgctccagcgaaagcggtcctcgccgaaaatgacccagagcgctgccggcacctgtcctacgagttgcatgataaagaagacagtcataagtgcggcgacgatagtcatgccccgcgcccaccggaaggagctgactgggttgaaggctctcaagggcatcggtcgacgctctcccttatgcgactcctgcattaggaagcagcccagtagtaggttgaggccgttgagcaccgccgccgcaaggaatggtgcatgcaaggagatggcgcccaacagtcccccggccacggggcctgccaccatacccacgccgaaacaagcgctcatgagcccgaagtggcgagcccgatcttccccatcggtgatgtcggcgatataggcgccagcaaccgcacctgtggcgccggtgatgccggccacgatgcgtccggcgtagaggattcacaggacgggtgtggtcgccatgatcgcgtagtcgatagtggctccaagtagcgaagcgagcaggactgggcggcggccaaagcggtcggacagtgctccgagaacgggtgcgcatagaaattgcatcaacgcatatagcgctagcagcacgccatagtgactggcgatgctgtcggaatggacgatatcccgcaagaggcccggcagtaccggcataaccaagcctatgcctacagcatccagggtgacggtgccgaggatgacgatgagcgcattgttagatttcatacacggtgcctgactgcgttagcaatttaactgtgataaactaccgcattaaagcttatcgatgataagctgtcaaacatgagaa

Example 12 Standard BLI Potentiation MIC Assay

The ability of compounds to potentiate the activity of β-lactams wasdemonstrated by determining the minimum inhibitory concentrations (MIC)of β-lactam and BLI compound combinations against various β-lactamaseproducing bacterial strains using the broth microdilution method. Theexperimental protocol was performed according to Clinical and LaboratoryStandards Institute (CLSI) guidelines with modifications as describedbelow (CLSI guidelines can be derived from the CLSI document M07-A9published in January 2012: “Methods for Dilution AntimicrobialSusceptibility Tests for Bacteria That Grow Aerobically; ApprovedStandard-Ninth Edition”).

To prepare for MIC testing, frozen glycerol stocks of clinical isolates(Klebsiella pneumoniae, Eschericia coli, Enterobacter spp, Citrobacterspp, or Pseudomonas aeruginosa) were used to streak for isolatedcolonies on rich, non-selective, tryptic soy agar containing 5% sheep'sblood (TSAB). Frozen glycerol stocks of laboratory engineered, isogenicE. coli strains, which contain cloned β-lactamase expressing plasmidswere used to streak for isolated colonies on rich, selective LB agarsupplemented with 25 μg/mL tetracycline to maintain the plasmid. Allstrains were incubated at 37° C. for 18-24 hrs.

On the day of testing, primary cultures were started by scraping off5-10 colonies from the TSAB plates containing clinical strains or thetetracycline supplemented LB plates containing engineered strains. Theclinical strain material was suspended in ˜5 mL of cation adjustedMueller Hinton Broth (CAMHB) in 14 mL culture tubes. The engineeredstrain material was suspended in CAMHB (supplemented with 25 ug/mLtetracycline) in 14 mL culture tubes. All strains were incubated at 37°C. with aeration (200 rpm) for ˜2 hrs until the optical density at 600nm (OD600) was ≧0.1.

The two compound components of the assay were each diluted in CAMHB andadded to the 96-well broth microdilution assay plates. 50 μL of theβ-lactam was added to each well of the assay plate in 2-fold dilutionswith final concentrations ranging from 128-0.13 μg/mL. 25 μL of the BLIcompound was added to all wells in the broth microdilution plates at afinal concentration of 4 μg/mL. Inoculum cultures were prepared bystandardizing the primary cultures to OD600=0.1 and then adding 20 μL ofthe adjusted primary culture per 1 mL CAMHB for clinical strains orCAMHB (supplemented with tetracycline at 100 μg/mL) for engineeredstrains, so that the final inoculum density was ˜10⁵ colony formingunits per milliliter. Diluted inoculum cultures were used to inoculate25 μL per well in 96-well broth microdilution assay plates. The finalvolume of each well was 100 μL and contained a β-lactam at differentconcentrations, a BLI compound at 4 μg/mL concentration, the bacterialculture at an OD600 of approximately 0.001 and when necessarytetracycline at 25 μg/mL.

Plates were incubated for 18-20 hours at 37° C. with aeration (200 rpm).Following incubation, growth was confirmed visually placing plates overa viewing apparatus (stand with a mirror underneath) and then OD600 wasmeasured using a SpectraMax 340PC384 plate reader (Molecular Devices,Sunnyvale, Calif.). Growth was defined as turbidity that could bedetected with the naked eye or achieving minimum OD600 of 0.1. MICvalues were defined as the lowest concentration producing no visibleturbidity.

MIC values of representative compounds are shown in Table II.

Example 13 Synergy MIC (sMIC) Assay

The synergy MIC (sMIC) assay determines the concentration of the BLIrequired to potentiate the activity of a fixed concentration of aβ-lactam antibiotic against β-lactamase producing bacterial strains. Theexperimental protocol was performed according to Clinical and LaboratoryStandards Institute (CLSI) guidelines with modifications as describedbelow (CLSI guidelines can be derived from the CLSI document M07-A9published in January 2012: “Methods for Dilution AntimicrobialSusceptibility Tests for Bacteria That Grow Aerobically; ApprovedStandard-Ninth Edition”). The assay is set-up by serially diluting theBLI across 11 of the 12 wells in each row of a 96-well brothmicrodilution assay plate, adding the β-lactam at a fixed concentrationto all wells in the assay plate, inoculating the assay plate withbacterial strains, and determining the lowest concentration of BLIrequired to inhibit overnight bacterial growth. Bacterial growth in the12^(th) well of the assay plate, which contains the β-lactam at a fixedconcentration but does not contain any BLI, demonstrates that thebacterial strains are resistant to the β-lactam antibiotic (e.gceftolozane) at the fixed concentration of 4 μg/mL.

To prepare for MIC testing, frozen glycerol stocks of clinical isolates(Klebsiella pneumoniae, Eschericia coli, Enterobacter spp, Citrobacterspp, or Pseudomonas aeruginosa) were used to streak for isolatedcolonies on rich, non-selective, tryptic soy agar containing 5% sheep'sblood (TSAB). Frozen glycerol stocks of laboratory engineered, isogenicE. coli strains, which contain cloned β-lactamase expressing plasmidswere used to streak for isolated colonies on rich, selective LB agarsupplemented with 25 μg/mL tetracycline to maintain the plasmid. Allstrains were incubated at 37° C. for 18-24 hrs.

On the day of testing, primary cultures were started by scraping off5-10 colonies from the TSAB plates containing clinical strains or thetetracycline supplemented LB plates containing engineered strains. Theclinical strain material was suspended in ˜5 mL of cation adjustedMueller Hinton Broth (CAMHB) in 14 mL culture tubes. The engineeredstrain material was suspended in CAMHB (supplemented with tetracyclineat 25 μg/mL) in 14 mL culture tubes. All strains were incubated at 37°C. with aeration (200 rpm) for ˜2 hrs until the OD600 was ≧0.1.

The two compound components of the assay were each prepared in CAMHB andadded to the 96-well broth microdilution assay plates. 50 μL of the BLIwas added to each well of the assay plate in 2-fold dilutions with finalconcentrations ranging from 128 to 0.13 μg/mL. 25 μL of the β-lactam wasadded to all wells in the broth microdilution plates at a finalconcentration of 4 μg/mL. Inoculum cultures were prepared bystandardizing the primary cultures to OD600=0.1 and then adding 20 μL ofthe adjusted primary culture per 1 mL CAMHB for clinical strains orCAMHB (supplemented with tetracycline at 100 μg/mL) for isogenicstrains, so that the final inoculum density was ˜10⁵ colony formingunits per milliliter. Diluted inoculum cultures were used to inoculate25 μL per well in 96-well broth microdilution assay plates. The finalvolume of each well was 100 μL and contained a BLI at differentconcentrations, a β-lactam at 4 μg/mL concentration, the bacterialculture at an OD600 of approximately 0.001 and when necessarytetracycline at 25 ug/mL.

Interpreting the sMIC Data:

Plates were incubated for 18-20 hours at 37° C. with aeration (200 rpm).Following incubation, growth was confirmed visually placing plates overa viewing apparatus (stand with a mirror underneath) and then OD600 wasmeasured using a SpectraMax 340PC384 plate reader (Molecular Devices,Sunnyvale, Calif.). Growth was defined as turbidity that could bedetected with the naked eye or achieving minimum OD600 of 0.1. sMICvalues were defined as the lowest concentration producing no visibleturbidity.

The sMIC values represent the amount of BLI required to potentiate theactivity of 4 μg/ml of CXA-101 (Ceftolozane) or ceftazidime to inhibitthe growth of the β-lactamase producing bacteria.

sMIC values of representative compounds are shown in Table III.

Example 14 Inhibition Kinetics

Inhibition or inactivation of KPC-2 by test inhibitors was assessedusing 100 μM nitrocefin (NCF) as a reporter substrate. Assays wereperformed in 1×PBS pH 7.4, 0.1 mg/ml BSA, in 96-well half area plates,50 μl reaction volume. NCF was dissolved in DMSO and diluted in assaybuffer. Test inhibitors were dissolved in water or DMSO and seriallydiluted in the assay with final concentrations between 2000-0.195 μM.

The enzyme activity in the presence of varying concentrations of testinhibitor was determined by monitoring the hydrolysis of NCFspectrophotometrically at 486 nm, for 5 minutes, 25° C., using aSpectraMax Plus384 microplate reader with SoftMax Pro software(Molecular Devices). Data analysis was performed using GraphPad Prism(GraphPad Software, Inc.).

Progress curves were fit to a first-order rate decay equation (Eq. 1) todetermine k_(observed) (k_(obs)).

k_(obs) vs. inhibitor concentration [I] curves were then fit to Eq. 2 todetermine the inhibitor dissociation constant (K) and the first orderrate constant of enzyme inactivation at infinite inhibitor concentration(k_(inact)). Table IV shows kinetics results from representative testcompounds. A larger k_(inact)/K ratio indicates a more effective enzymeinactivator.

Y _(t) =V ₀*(1−e ^((−k) _(obs) *^(t)))/k _(obs)  Eq. 1

Where Y is the absorbance at time t, V₀ is the uninhibited enzymevelocity, k_(obs) is the observed rate constant of the enzymeinactivation.

k _(obs) =k _(inact) *[I]/([I]+K(1+S/K _(m)))  Eq. 2

Where S is the NCF concentration, K_(m) is the KPC-2 K_(m) for NCF.

1.-37. (canceled)
 38. A pharmaceutical composition comprising aztreonamor a pharmaceutically acceptable salt thereof and a compound of Formula(I) or a pharmaceutically acceptable salt thereof:

wherein Z is selected from a 1,2,4-oxadiazole or a 1,2,4-thiadiazole; Ris selected from

and R¹ is selected from: hydrogen,

wherein R² is selected from

wherein each of R³, R⁴ and R⁵ is independently selected from hydrogen,(C₁-C₃)-alkyl, aminoalkyl, aminocycloalkyl, or hydroxyalkyl, and n isselected from 1, 2 or 3, amino,

wherein R⁶ is selected from H, (C₁-C₃)-unsubstituted alkyl,amino-(C₂-C₃)-alkyl, aminocycloalkyl, hydroxyalkyl,

and each of p and q is independently selected from 1 or 2; and—CH₂(R⁷)CH₂NH₂ wherein R⁷ is selected from amino or hydroxyl.
 39. Thepharmaceutical composition of claim 38 wherein Z—R¹ is

wherein X is selected from O or S and wherein R and R¹ are as previouslydescribed.
 40. The pharmaceutical composition of claim 38 wherein Z—R¹is

wherein X is selected from O or S and wherein R and R¹ are as previouslydescribed.
 41. The pharmaceutical composition of claim 38 wherein thecompound of Formula (I) exhibits a binding affinity for the KPC-2β-lactamase enzyme of at least 250 mM⁻¹s⁻¹.
 42. The pharmaceuticalcomposition of claim 38 wherein the compound is selected from the groupconsisting of Formula (III), Formula (IV), Formula (V), Formula (VI),Formula (VII) and Formula (VIII), and pharmaceutically acceptable saltsthereof:


43. The pharmaceutical composition of claim 38 wherein the compound or apharmaceutically acceptable salts thereof has the Formula:


44. The pharmaceutical composition of claim 38 wherein the compound or apharmaceutically acceptable salts thereof has the Formula:


45. A pharmaceutical composition comprising meropenem or apharmaceutically acceptable salt thereof and a compound of Formula (I)or a pharmaceutically acceptable salt thereof:

wherein Z is selected from a 1,2,4-oxadiazole or a 1,2,4-thiadiazole; Ris selected from

and R¹ is selected from: hydrogen,

wherein R² is selected from

wherein each of R³, R⁴ and R⁵ is independently selected from hydrogen,(C₁-C₃)-alkyl, aminoalkyl, aminocycloalkyl, or hydroxyalkyl, and n isselected from 1, 2 or 3, amino,

wherein R⁶ is selected from H, (C₁-C₃)-unsubstituted alkyl,amino-(C₂-C₃)-alkyl, aminocycloalkyl, hydroxyalkyl,

and each of p and q is independently selected from 1 or 2; and—CH₂(R⁷)CH₂NH₂ wherein R⁷ is selected from amino or hydroxyl.
 46. Thepharmaceutical composition of claim 45 wherein Z—R¹ is

wherein X is selected from O or S and wherein R and R¹ are as previouslydescribed.
 47. The pharmaceutical composition of claim 45 wherein Z—R¹is

wherein X is selected from O or S and wherein R and R¹ are as previouslydescribed.
 48. The pharmaceutical composition of claim 45 wherein thecompound of Formula (I) exhibits a binding affinity for the KPC-2β-lactamase enzyme of at least 250 mM⁻¹s⁻¹.
 49. The pharmaceuticalcomposition of claim 45 wherein the compound is selected from the groupconsisting of Formula (III), Formula (IV), Formula (V), Formula (VI),Formula (VII) and Formula (VIII), and pharmaceutically acceptable saltsthereof:


50. The pharmaceutical composition of claim 45 wherein the compound or apharmaceutically acceptable salts thereof has the Formula: